Interpretation of endometrium obtained by the Endo-pap sampler and a clinical study of its use.

Endometrical cytology sampling using the Endo-pap sampler is an inexpensive, painless, and simple procedure. Tissue microfragments obtained include surface epithelial sheets, gland segments, and stromal cell aggregates. Gland segments are critical for evaluation of the sample. Glands are dilated in hyperplasia and there is nuclear crowding with increase of chromatin and nucleoli. In adenocarcinoma there is loss of glands with marked nuclear enlargement and pleomorphism. An understanding of endometrial histomorphology and its correlation with cytology is essential for accurate interpretation. In 1027 ambulatory patients screened, no complications were observed and 92% of the samples were adequate for cytologic diagnosis. Tissue diagnosis was obtained in 173 cases. There were 36 adenocarcinomas, of which 34 (94%) were diagnosed cytologically. There were 16 hyperplasias, of which 5 (31%) were diagnosed cytologically. The Endo-pap sampler was found effective in detecting endometrial adenocarcinoma. Further studies are needed to determine its diagnostic effectiveness in hyperplasia.