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Endometrial cells on pap
An_244405 posted:
I recently had my yearly pap and the report came back Endometrial Cells in a woman >=40. Everything else was normal. Also under comments it said Endometrial cells present correlate with menstrual history. My gyno says that anyone 40 and above they are recommended to do a endometrial biopsy. I just turned 40 this year. Everything I read on the internet suggest that it is normal to find endometrial cells if pap was done near menstrual cycle. Mine was three days after my cycle. I am feeling that that a biopsy is not necessary and that I may be having an unnecessary procedure and have also heard of the horror stories with these so that even makes me more apprehensive. I have no symptoms, no unusual bleeding, period every 28-30 days. I also had a pelvic ultrasound done which came back normal. Just wondering what everyone's thought were on this or if anyone else has been through this. Thank you.
someonewhocares3 responded:
A pap smear checks for cervical dysplasia. An endometrial biopsy checks for endometrial (uterine) hyperplasia. I didn't think a pap smear could give any indication of the status of the endometrium so not sure what this test is indicating.

I agree that there seems to be something amiss here as your menstrual history and ultrasound would indicate everything's fine.

You can read about endometrial hyperplasia and cervical dysplasia here -
Endometrial Hyperplasia
Cervical dysplasia

Hope this info helps! Post back and let us know what you find out.
Jane Harrison Hohner, RN, RNP responded:
Dear An: I concur with your diagnosis. The presence of endometrial cells (cells from the lining of the uterus)--especially if one has had recent bleeding/menstruation--is normal. The cells float down the cervical canal where they get picked up on the PAP smear.

What is NOT normal would be if those endometrial cells showed abnormal changes (eg cellular atypia) or if the woman was postmenopausal. I even know of a case of a young women who had her ovarian cancer detected when ovarian cancer cells were shed and somehow made their way through the Fallopian tube and thence out the cervical canal. In her case ovarian cancer was picked up on a PAP smear (VERY rare).

I do not know your entire medical history. Perhaps you have some risk factor (eg severe overweight, diabetic, family history of uterine cancer) which makes your GYN very cautious.

Given that your ultrasound did not show a thickened uterine lining, a focal thickness, or an uneven thickness of the lining it seems less likely that you have an area of concern which is shedding endometrial cells (eg cancer). PLEASE go back and talk with your GYN. Don't just disappear from care. See if there is some specific reason, beyond fear of litigation, to explain their desire to do an endometrial biopsy.

If a biopsy is indicated you should take their advice. I've had over 20 (training others to do them, and a few for research studies). They are not my favorite thing, but the pain is short lived.


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