By Leopold G. Koss and Dulcie V. Coleman (Auth.)
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Additional resources for Advances in Clinical Cytology
Endometrial neoplasia Invasive carcinomas, with a few exceptions, are thought to develop from in situ carcinomas. In the endometrium, carcinoma in situ was described as a separate entity as early as 19491. However, its existence has remained highly controversial ever since. Also, a clear-cut stepwise progression of events from hyperplasia to carcinoma in situ has not been accepted universally. e. early endometrial neoplasia). They also recognize the difficulty of demonstrating early stromal invasion of the endometrium.
The least complicated was to prepare smears from the deposit after centrifugation, but membrane filters were also used, as well as cell block methods. Flotation techniques could be employed to separate red blood cells from the final specimen. The first reports of the Gravlee jet-washer were encouraging6,12 but more recent work1 has been unable to substantiate these early findings. Although patient acceptability was high, the overall accuracy of the diagnosis of adenocarcinoma was only 50%. Cell morphology was poorly preserved by this method and the technique was eventually abandoned.
Although Vabra in the hands of some clinicians can achieve a high level of patient acceptability16,36, not all studies have shown this21,45. Samples obtained by the Vabra may be abundant but some studies have shown a high rate of inadequate samples34,41,43. Sturdee and colleagues43 failed to obtain a satisfactory specimen in 18% of patients although they reported a high level of accuracy in their assessment of endometrial status in those cases where adequate samples were obtained. They suggested that endometrial aspiration may be a more successful method of obtaining a specimen from some of these patients.