Peritoneal washing cytology on fluid hysteroscopy and after curettage in women with endometrial carcinoma

OBJECTIVE: To assess the influence of fluid hysteroscopy with target biopsy of the endometrium and the influence of added curettage on the results of peritoneal washing cytology (PWC) in endometrial carcinoma. STUDY DESIGN: In 42 women at risk of endometrial carcinoma, we performed fl uid hysteroscopy with target biopsy of the endometrium and curettage. Evalu ation of PWC of the pouch of Douglas was performed three times during the p rocedure: prior to hysteroscopy, after fluid hysteroscopy with target biops y and after curettage. RESULTS: On cytologic slides from peritoneal washings in 11 patients with c arcinoma of the endometrium, malignant endometrial cells were found after c urettage in 72.7%. There was no statistically significant difference in PWC prior to hysteroscopy (two women, 20%) or after hysteroscopy with target b iopsy (three women, 30%). There was a statistically significant difference (.05 level) in positive PWC after hysteroscopy with target biopsy (three wo men, 33.3%) and after curettage (eight women, 88.9%). CONCLUSION: Slides from carcinoma of the endometrium in PWC do not deterior ate after hysteroscopy with target biopsy of the endometrium, but tumor cel ls will appear in the pouch of Douglas after curettage.