Pap in patient >40 yo showing endometrial cells

Question 1

A 52-year-old menopausal woman comes to your office for her annual examination. She has not experienced spotting or vaginal bleeding since menopause 18 months ago. Her sister has a history of cervical cancer. Her Pap test results are “satisfactory with no malignancy” with the notation of “endometrial cells present in a woman older than 40 years.” The next step in her evaluation is:

(A) endometrial assessment
(B) high-risk human papillomavirus testing
(C) repeat cervical cytology in 6 months
(D) colposcopy with endocervical curettage

Answer 1

(A) endometrial assessment

Question 2

What is the significance of endometrial cells in cervical cytology of asymptomatic postmenopausal women (even when cervical cells are normal)?

Answer 2

Significantly greater risk of uterine pathology! ALWAYS need an endometrial assessment with EMB or D&C