Endometrial brush biopsy (Tao brush) - Histologic diagnosis of 200 cases with complementary cytology: An accurate sampling technique for the detection of endometrial abnormalities

We examined 200 cases of endometrial brush biopsy (EBB) using the Tao brush and correlated findings with histologic findings from subsequent dilatatio n and curettage (D&C) or hysterectomy specimens. Diagnosis bq, EBB relied m ainly on histologic evaluation of H&E-stained tissue sections and was compl emented bg additional cytologic smear examination. EBB correctly detected t he following cases: endometrioid adenocarcinoma, 3: complex hyperplasia wit h atypia, 1; simple hyperplasia without atypia (SH), 2; and benign endometr ium, 177. In 3 cases the diagnosis of atrophic endometrium was made by EBB; corresponding D&C specimens were nondiagnostic. Five cases of SH were inte rpreted by EBB as proliferative endometrium, and 13 endometrial polyps were not identified by EBB. Nine samples were nondiagnostic. Sensitivity and sp ecificity were 100% for detecting atypical hyperplasia and carcinoma. Howev er it was difficult for EBB to distinguish SH from disordered proliferative endometrium or to diagnose endometrial polyps. We found that diagnosis by EBB is reproducible; a second pathologist blinded to histologic follow-up c orrectly, identified all adenocarcinoma atypical hyperplasia cases. EBB is an accurate, safe, and easy procedure that is well tolerated by patients an d should be considered in the initial evaluation of high-risk outpatients.