Many tend to think of cytology as a nucleus-centered diagnostic method that gives little consideration to tissue structure. However, as the Gynecologic Oncology Group’s pathology committee moved its diagnostic benchmarks of endometrial cancer from a purely tissue-pattern approach to grading and included nuclear features as an adjunct to cancer diagnosis, so cytopathologists moved from a nucleus-centered diagnosis of endometrial abnormalities to one that considered definable three-dimensional patterns. Confocal microscopy, an optical imaging technique whose concept was patented by Marvin Minsky in 1957, has been used to reconstruct three-dimensional images of specimens that are thicker than the focal plane. Confocal microscopic “sectioning” of endometrial cytology microbiopsies present on thick smears showed, in addition to mitotic figures and altered chromatin patterns, glandular architecture and the shattered remnants of tissue patterns.
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Maksem, J.A., Robboy, S.J., Bishop, J.W., Meiers, I. (2009). Cytoarchitecture and Nuclear Atypia as the Bases for the Cytology Risk-Stratification of Endometrial Samplings. In: Endometrial Cytology with Tissue Correlations. Essentials in Cytopathology, vol 7. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-89910-7_4
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