title: Cytological Study of Grade 3 Endometrioid Adenocarcinoma of Endometrial Origin: Cytoarchitecture and Features of Cell Clusters Assessed With Endometrial Brushing Cytology--Focusing on a comparison with endometrioid adenocarcinoma Grade 1, 2.
abstract: OBJECTIVE
  Aim of study was to clarify the cytological characteristics of grade 3 endometrioid adenocarcinoma of endometrial origin (G3 EA) by endometrial brushing cytology.
  
  
  METHODS
  The subjects were 11 patients in whom G3 EA was diagnosed by review of preoperative cytological specimens obtained at our hospital and related institutions between 2000 and 2010. These patients were investigated with respect to the preoperative cytological diagnosis, background changes, cell cluster patterns, and individual cellular findings. Background changes were classified as inflammatory or tumorous, while cell clusters were classified as overlapping cell cluster, sheet-like cell cluster, clump of high dense gland, papillary, or other cell cluster. Cellular findings were investigated by comparing the incidence of squamous and clear cell metaplasia, the nuclear rounding rate, and the nuclear area with the findings in a control group (35 patients with G1-2 EA).
  
  
  RESULTS
  Background changes were classified as inflammatory in 63.6% and necrotic in 36.4%. The cell clusters were classified as overlapping cell cluster in 44.8%, cell cluster in 21.7%, clump of high dense gland in 10.0%, papillary in 4.0%, and other cell cluster in 19.5%. The incidence of squamous and clear cell metaplasia was 27.2% and 18.1%, respectively. The mean nuclear rounding rate was 0.97, and the mean nuclear area was 55.98 µm2.
  
  
  CONCLUSIONS
  Investigation of the cytoarchitecture of G3 EA with endometrial brushing cytology revealed overlapping cell cluster and tumor cells of a relatively uniform size. These findings suggest that it is necessary to recognize that there are differences between the cytological findings of G3 EA and the usual features of G1-2 EA.
authors.forename: Naruaki
authors.initials: N
authors.lastname: Matsui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kajiwara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morishita
authors.forename: Hitomi
authors.initials: H
authors.lastname: Tsukada
authors.forename: Kazumi
authors.initials: K
authors.lastname: Nakazawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Mikio
authors.initials: M
authors.lastname: Mikami
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Pathology, Tokai University Oiso Hospital, 21-1 Gakkyo, Oiso-machi, Nakagun, Kanagawa 259-0198, Japan. snsato@air.so-net.jp.
authors.forename: Shinkichi
authors.initials: S
authors.lastname: Sato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000473:pathology*; D003581:Cytodiagnosis / Q000379:methods*; D003584:Cytological Techniques / Q000379:methods*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D014407:Tumor Cells, Cultured