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Atlas Interpretation:
Interpreted image
Type of Preparation:
ThinPrep/ LBP

Magnification:
High

Clinical History:
43 year old whose LMP not available. She has no symptoms of bleeding

Interpretation:
Endometrial cells are present in a woman >= 40 years of age. Negative for squamous intraepithelial lesion. (See Note)
Note: Endometrial cells after age 40, particularly out of phase or after menopause may be associated with benign endometrium, hormonal alterations and less commonly, endometrial /uterine abnormalities. Clinical correlation is recommended

Cytomorphologic Criteria:
Three dimensional groups with depth of focus. Dark stromal cells are present internally. Epithelial cells surround the cluster in a "double contour." Nuclear features of epithelial and stromal cells are more readily apparent in ThinPrep specimens than conventional smears.

Explanatory Notes:
Exfoliated glandular endometrium may be seen when evaluating Pap tests. When endometrial cells are encountered in a woman 40 or older, they are uncommonly associated with significant pathology. Rarely, typical endometrial cells may be associated with an asymptomatic endometrial carcinoma in this age group. Because of this association, all glandular endometrial cells are reported in women 40 years and over.

Follow-up:
No symptoms for 3 years following this Pap preparation. Subsequent Pap tests have been negative

Bethesda Interobserver Reproducibility Data:
NILM: Negative for Intraepithelial Lesion or Malignancy # people picked NILM: Negative for Intraepithelial Lesion or Malignancy 70 12%
Endometrial cells in a woman >= 40 # people picked Endometrial cells in a woman >= 40 470 78%
ASC-US # people picked ASC-US 3 0%
ASC-H # people picked ASC-H 3 0%
LSIL # people picked LSIL 0 0%
HSIL # people picked HSIL 1 0%
Invasive Squamous Cell Carcinoma # people picked Invasive Squamous Cell Carcinoma 2 0%
Atypical Endocervical Cells # people picked Atypical Endocervical Cells 16 3%
Atypical Endometrial Cells # people picked Atypical Endometrial Cells 29 5%
Adenocarcinoma in situ (AIS), Endocervical # people picked Adenocarcinoma in situ (AIS), Endocervical 4 1%
Adenocarcinoma # people picked Adenocarcinoma 6 1%
 
604 interpretations were submitted.

See Also: thumbnail for figure MES-exodus.jpg
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