Endometrial biopsy
Taking a tissue sample of endometrium.
Most reliable method to study the endometrium is by obtaining the material by curettage after dilatation of the cervix under the general anaesthesia.
Done in suspected cases of genitals TB.
Indications –
- Abnormal Uterine bleeding
- Cancer screening
- Endometrial dating
- Infertility evaluation
Interpretation of the reports
1. Biopsy results – Normal
- Atrophic endometrium
- Proliferative endometrium
- Secretory endometrium
2. Biopsy results – Abnormal
- Endometrial cancer
- Endometrial hyperplasia
PAP Smear
Papanicolaou’s Smear for Exfoliative cytology- A test carried on a sample of cell collected from Cervical mucous.
Indications-
- As a screening procedure for Cervical cancer.
- For cytohormonal study
- Sex chromatin study
- Aspirated ascitic, cystic or pleural fluid is subjected to PAP stain for evidences of malignant cells.
Procedure-
- Collection of Material-
- cervix exposed with Cusco’s vaginal speculum.
- Collection is done using ayre’s spatula from squamocolumnar junction.
- By cytobrush taking endocervical sampling.
- By wooden spatula from lateral vaginal cervix.
2. Fixation and staining-
Material collected is immediately spread over microscopic slide and at once put into fixative ethyl alcohol.
It is air dried and sent to laboratory where it is stained by Papanicolaou’s Method.
Benifits- Its objective is to reduce the incidence and mortality from Cervical cancer. Pap smear test has been effective reducing the incidence of Cervical cancer by 80% and the mortality by 70%.
Papanicolaou’s Grading
- Group 1- Normal
- Group 2- Presence of borderline atypical cells- probably due to infection. No evidence of malignancy
- Group 3- cells suspicious of malignancy
- Group 4- Presence of few malignant cells.
- Group 5- Presence of large number of malignant cells.