Endocervical cell collection using cytobrush, liquid-fixation, and cytocentrifugation: A feasibility study using 455 hysterectomy specimens

Differential uterine curettage may be performed for the evaluation of abnormal uterine bleeding. The purpose of this study was to test the feasibility of substituting cytological methods for differential uterine curettage to evaluate the entire glandular axis of the uterus and the transformation zone. In order to simulate differential uterine sampling, the endocervix was brushed in 455 uteri from which an endometrial cytology sample had been previously collected. Twenty-five percent of the brushes' cell-sample was examined using two 17.5 mm circle-slides prepared with a Hettich cytocentrifuge. The resulting slides were homogeneous and cellular. They were compared to tissue sections of matched hysterectomy specimens. Endometrial adenocarcinoma was overrepresented in the endocervical cytology preparations. This was ascribed either to prior endometrial collection with "drop-down contamination" of the endocervix and/or to entry of the cytobrush into the endometrial cavity. Otherwise, cytological and histological diagnoses were comparable for squamous and endocervical-adenomatous lesions. Under the conditions of this simulation, endometrial and endocervical brushings appeared to complement each other as case-finding techniques for evaluating abnormal uterine bleeding. Diagn. Cytopathol. 1999;21:419-426.