title: Significance of benign endometrial cells in Pap smears from postmenopausal women.
abstract: OBJECTIVE
  To assess the significance of benign exfoliated endometrial epithelial or stromal cells on cervicovaginal Pap smears obtained from postmenopausal women not receiving exogenous hormones.
  
  
  METHODS
  A computerized search of the cytology database at two institutions was performed for a five-year period, and all cervical cytology cases from postmenopausal patients diagnosed with benign endometrial cells were identified. Those cases with histologic follow-up within 12 months of the original cytologic evaluation were selected for analysis, and their cytology and surgical pathology slides were reviewed.
  
  
  RESULTS
  A total of 227 postmenopausal women with benign endometrial cells were identified. Of the 61 patients with histologic follow-up, 25 (41%) had significant endometrial diseases, including hyperplasia without atypia (11), atypical endometrial hyperplasia (5), well-differentiated adenocarcinoma (8) and high grade serous carcinoma (1). Benign diagnoses, including atrophy (15), weakly proliferative endometrium (9) and proliferative endometrium (6), were noted in 30 patients (49%). Endometrial polyp was identified in three patients (5%). There were three cases of nondiagnostic histologic specimens that lacked endometrial tissue (5%). Two of nine women (22%) with proven carcinoma were asymptomatic.
  
  
  CONCLUSIONS
  The diagnosis of endometrial cells, cytologically benign, in a postmenopausal woman not receiving hormone on Pap smears is associated with a significant number of cases of endometrial hyperplasia, atypical hyperplasia and carcinoma.
authors.affiliation: Department of Pathology, Ball Memorial Hospital, 2401 University Avenue, Muncie, IN 47303, USA. wuh@palab.com
authors.forename: H H
authors.initials: HH
authors.lastname: Wu
authors.forename: M J
authors.initials: MJ
authors.lastname: Schuetz
authors.forename: H
authors.initials: H
authors.lastname: Cramer
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000453:epidemiology / Q000473:pathology; D004714:Endometrial Hyperplasia / Q000453:epidemiology / Q000473:pathology; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D004717:Endometrium / Q000166:cytology*; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D065006:Papanicolaou Test; D017698:Postmenopause; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014626:Vaginal Smears / Q000592:standards*