Significance of "normal" endometrial cells in cervical cytology from asymptomatic postmenopausal women receiving hormone replacement therapy.
OBJECTIVE
The aim of this study is to assess the significance of normal endometrial cells identified in screening Pap smears from asymptomatic postmenopausal women taking hormone replacement therapy (HRT).


METHODS
Endometrial histology reported from 93 asymptomatic postmenopausal women receiving HRT noted to have normal endometrial cells on a screening Pap smear was reviewed. Information regarding HRT, endometrial sampling, and interval between the sentinel Pap and sampling was extracted from the record.


RESULTS
Endometrial biopsies were obtained an average of 1.7 months after the Pap smears. Eighteen of the ninety-three histology specimens (19%, 95% CI: 12--27%) identified abnormalities, in four cases precancerous or cancerous lesions. These 18 abnormalities included 7 endometrial polyps; 7 cases of simple hyperplasia, 1 with atypia; 3 cases of complex hyperplasia, 1 with atypia; and 1 endometrial adenocarcinoma.


CONCLUSIONS
Normal endometrial cells identified on a screening Pap smear in this population may be an indication of endometrial disease.
The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, The Johns Hopkins Hospital and Medical Institutions, 600 North Wolfe Street, Baltimore, Maryland 21287-1248, USA. fmontz@jhmi.edu
F J
FJ
Montz
D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000166:cytology*; D016889:Endometrial Neoplasms / Q000473:pathology; D004717:Endometrium / Q000166:cytology* / Q000473:pathology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000009:adverse effects; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008875:Middle Aged; D011127:Polyps / Q000473:pathology; D017698:Postmenopause; D011230:Precancerous Conditions / Q000473:pathology
D004967:Estrogens