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Cervix-Cytology

Normal cells / non-neoplastic findings

Endometrial cells

Reviewer: Xinmin Zhang, M.D., Temple University (see Reviewers page)
Revised: 6 October 2010, last major update August 2010
Copyright: (c) 2006-2010, PathologyOutlines.com, Inc.

Definition / General
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● Spontaneously exfoliated endometrial cells are often seen during the first 12 days of the menstrual cycle
● May also be due to hormone replacement therapy (Obstet Gynecol 2002;100:445) or tamoxifen
● Endocervical sampling devices may inadvertently sample the lower uterine segment or endometrium

Clinical features
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● Variable association of benign endometrial cells at pap smear with endometrial pathology in postmenopausal women (yes: Am J Clin Path 2005;123:571, Diagn Cytopathol 2001;45:153), (no association: Cancer 2005;105:207, Diagn Cytopathol 2001;25:235)
● Most associated carcinomas are in women age 45+ years (Am J Clin Pathol 2005;124:834)

Cytology description
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● Exfoliated endometrial cells often present as small cells arranged in balls with scant cytoplasm, dark nuclei and nuclear molding and fragmentation
● Abraded endometrial cells may present as large and small tissue fragments with glands and stromal cells
● Resemble histiocytes
● Easier to identify if in clusters

Cytology images
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IUD related changes

Thin Prep of normal endometrial group-postmenstrual cycle, contributed by Dr. Carmen Luz, Spain:

Differential diagnosis
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● Adenocarcinoma in situ
● HSIL
● Small cell carcinoma
● Small cell squamous cell carcinoma

End of Cervix-cytology > Normal cells / non-neoplastic findings > Endometrial cells

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