Atypical Endometrial Cells in Post-menopause- Case Report

The presence of endometrial cells is considered an alarming finding in the gynecological smears of women in the second half of the menstrual cycle or women aged ≥ 45 years. In the case of postmenopausal women, the presence of atypical endometrial cells may represent endometrial abnormality and requires careful evaluation. We report a case of a 77 year-old postmenopausal woman, who presented abnormal vaginal bleeding. A cervical/vaginal cytology revealed the presence of abnormal endometrial cells in clusters and this fact was unusual in the woman’s clinical context. The cytological result was Atypical Glandular Cells, favor Neoplasia. Based on this result, the patient was submitted to an endometrial curettage. The histological result was carcinosarcoma so a radical hysterectomy was performed. In spite of the discordance among the cytological and histological results, this case shows the relevance of endometrial studies and allowed the carcinosarcoma diagnosis. Key-words: carcinosarcoma, atypical glandular cells, gynecological cytology, post-menopause, conventional cytology. Citotech Online – Case Review 31 Fig.2 – AGC – Isolated cell (conventional cytology, Papanicolaou stain, 400x) INTRODUCTION Endometrial cells with common morphology can be observed in the gynaecological smears of women in fertile age, during the first 12 days of the menstrual cycle, or of those who use intrauterine devices (IUD). However, if noticed in postmenopausal women, these cells can indicate a glandular pathology, which can be benign or malign. In these situations, complementary exams of endometrial evaluation, such as the endometrial curettage and the pelvic ultrasound, might be recommended 1,2 .