Endometrial brush biopsy

An accurate outpatient method of detecting endometrial malignancy

Howard Wu, Bryan D. Casto, Tarik M. Elsheikh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

OBJECTIVE: To describe 633 cases using the Tao Brush™ for endometrial biopsy (EBB) in an outpatient setting. STUDY DESIGN: Histologic follow-up specimens within six months of EBB in an outpatient setting were evaluated over a two-year period. Diagnosis by EBB relied mainly on histologic evaluation of hematoxylin and eosin-stained tissue sections and was complemented by additional cytologic smear examination in our laboratory. Diagnostic categories included the following: nondiagnostic (ND), benign endometrium (BE), hyperplasia without atypia (H), atypia (AT) and atypical hyperplasia (AH)/carcinoma (CA). The correlation between EBB and follow-up histology was analyzed. RESULTS: A total of 633 EBBs were evaluated. Diagnoses were rendered in 569 cases, with a diagnostic rate of 90%. Histologic follow-up was available for 156 patients. Twelve AH/CA diagnosed by EBB were confirmed by histologic follow-up as CA. However, there was one false positive case, in which EBB showed AH/CA and dilatation and curettage (D&C) revealed disordered, weakly proliferative endometrium. Nine of 10 EBBs with AT diagnoses were 3 CA, 1 AH and 5 BE on follow-up. Two of eight H had D&C follow-up that also showed H. Histologic follow-up was available in 114 of 538 benign EBBs and showed benign correlation in 112 cases. There were two false negative cases; the EBB diagnoses were atrophic endometrium and weakly proliferative endometrium, while D&C showed focal AH in both cases. Among the ND cases, 18 of 64 had tissue follow-up and disclosed 4 CA, 1 H, 12 BE and 1 ND. CONCLUSION: EBB is a reliable diagnostic tool for endometrial sampling in an outpatient setting. The sensitivity and specificity in identifying CA among satisfactory specimens is 100% and 96%, respectively, when AT or a more severe diagnosis is made by EBB. Assessment of specimen adequacy is important for pathologists interpreting EBB. In our study, four cases of adenocarcinoma were identified in the follow-up D&C in patients with nondiagnostic EBB.

Original languageEnglish (US)
Pages (from-to)41-45
Number of pages5
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume48
Issue number1
StatePublished - Jan 1 2003
Externally publishedYes

Fingerprint

Endometrium
Outpatients
Hyperplasia
Carcinoma
Biopsy
Neoplasms
Dilatation and Curettage
Hematoxylin
Eosine Yellowish-(YS)
Histology
Adenocarcinoma
Sensitivity and Specificity

Keywords

  • Endometrial cancer
  • Endometrial hyperplasia
  • Endometrium
  • Tao Brush™

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Endometrial brush biopsy : An accurate outpatient method of detecting endometrial malignancy. / Wu, Howard; Casto, Bryan D.; Elsheikh, Tarik M.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 48, No. 1, 01.01.2003, p. 41-45.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To describe 633 cases using the Tao Brush™ for endometrial biopsy (EBB) in an outpatient setting. STUDY DESIGN: Histologic follow-up specimens within six months of EBB in an outpatient setting were evaluated over a two-year period. Diagnosis by EBB relied mainly on histologic evaluation of hematoxylin and eosin-stained tissue sections and was complemented by additional cytologic smear examination in our laboratory. Diagnostic categories included the following: nondiagnostic (ND), benign endometrium (BE), hyperplasia without atypia (H), atypia (AT) and atypical hyperplasia (AH)/carcinoma (CA). The correlation between EBB and follow-up histology was analyzed. RESULTS: A total of 633 EBBs were evaluated. Diagnoses were rendered in 569 cases, with a diagnostic rate of 90{\%}. Histologic follow-up was available for 156 patients. Twelve AH/CA diagnosed by EBB were confirmed by histologic follow-up as CA. However, there was one false positive case, in which EBB showed AH/CA and dilatation and curettage (D&C) revealed disordered, weakly proliferative endometrium. Nine of 10 EBBs with AT diagnoses were 3 CA, 1 AH and 5 BE on follow-up. Two of eight H had D&C follow-up that also showed H. Histologic follow-up was available in 114 of 538 benign EBBs and showed benign correlation in 112 cases. There were two false negative cases; the EBB diagnoses were atrophic endometrium and weakly proliferative endometrium, while D&C showed focal AH in both cases. Among the ND cases, 18 of 64 had tissue follow-up and disclosed 4 CA, 1 H, 12 BE and 1 ND. CONCLUSION: EBB is a reliable diagnostic tool for endometrial sampling in an outpatient setting. The sensitivity and specificity in identifying CA among satisfactory specimens is 100{\%} and 96{\%}, respectively, when AT or a more severe diagnosis is made by EBB. Assessment of specimen adequacy is important for pathologists interpreting EBB. In our study, four cases of adenocarcinoma were identified in the follow-up D&C in patients with nondiagnostic EBB.",
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