Introduction
Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out-patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing pathologists. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. We also tried to observe the incidence of various pathology in different age groups presenting with abnormal uterine bleeding.

https://www.jogi.co.in/jul_aug_2011/11_oa_studyof_endometrial.pdf

Study of Endometrial Pathology in Abnormal Uterine Bleeding

Background: Perimenopause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more-or-less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Materials and Methods: A retrospective age specific comparative analysis of 219 perimenopausal women presenting with abnormal uterine bleeding was done who underwent endometrial sampling during a 4-year period from January 2008 to April 2012 at the Hakeem Abdul Hameed Centenary Hospital. Endometrial tissue collected by sampling procedures such as dilatation and curettage (D and C), endometrial biopsy and fractional curettage had been sent to the pathology laboratory for evaluation. Results: The most common clinical presentation was represented by menorrhagia (46.4%) followed by metrorrhagia (20%), menometrorrhagia, polymenorrhea, polymenorrhagia among others. Evaluation of the endometrium revealed various patterns on histopathology, functional causes accounted for majority of the diagnosis. Secretory endometrium seen in 71 cases (32.4%) was the most common. While proliferative endometrium on histopathology was the second most common diagnosis; seen in 67 patients (30.5%). Endometrial hyperplasia was seen in 24 (10.9%) cases out of which simple hyperplasia without atypia was seen in 19, complex hyperplasia without atypia was seen in 4 and complex hyperplasia with atypia was seen in 1 case. The other diagnoses, which accounted for the rest of the functional causes of atypical uterine bleeding, were disordered proliferative endometrium 15 cases (6.8%), luteal phase defects 3 cases (1.3%). Conclusion: Atypical uterine bleeding in perimenopausal women is most commonly dysfunctional in origin. In addition, a significant number show underlying organic pathologies thereby highlighting the importance of endometrial curetting and biopsy as a diagnostic procedure in the evaluation.

Morphological spectrum of endometrial pathology in middle-aged women with atypical uterine bleeding: A study of 219 cases

Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

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Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features. Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied. Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%). Conclusion: Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology. Journal of Pathology of Nepal (2012) Vol. 2, 297-300 DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882

/pdf/histopathological-study-of-endometrium-in-abnormal-uterine-1z1qf3h11v.pdf

Histopathological study of endometrium in abnormal uterine bleeding

Background: Abnormal uterine bleeding is the Common pre­ senting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri­menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non­organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. Aim: To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri­menopausal and post­ menopausal age groups. Material and Methods: The study included prospective analysis of 119 cases of endometrial samples in patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and H&E stained slides were studied. Patients were categorized into peri­menopausal (40­49 years) and post­ menopausal (> 50 years) age group. Results: A total of 119 specimens of endometrium were analyzed. Maximum number (73.94%) of cases were from peri­ menopausal age group. The most common presenting complaint was menorrhagia (48.86%) followed by post­menopausal bleeding (26.05%). In peri­menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endo metrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post­menopausal age group. Three cases of endometrial carcinoma were reported in post­ menopausal age group only. Conclusion: A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above the age of 40 years to find out organic lesions. Careful screening can detect early cancer of endometrium which has excellent prognosis and it will help in further management.

Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study

Dysfunctional uterine bleeding (DUB) is a clinical term used to describe bleeding not attributable to any underlying organic pathological condition. A total of 187 patients were included in the present study which were categorized in reproductive ( 50yrs) age groups. One hundred sixteen cases (62%) were in reproductive age group, 47 cases (25.1%) in perimenopausa l age group and 24 cases (12.8%) in postmenopausa l age group. Histopathological examination of dilatation and curettage (D&C) samples was done to elucidate the cause of DUB. In reproductive age group, proliferative endometrium was the most common finding (26.8%) followed by irregular maturation (25%).Complex hyperplasia was seen in 6 cases, out of which 1 case showed atypia. Nineteen cases (16.4%) showed associated endometritis. No case of malignancy was observed in this group. In perimenopausal age group, simple hyperplasia was the most frequent finding (29.8%).Complex hyperplasia was seen in 3 cases, out of which 1 revealed atypia. Three cases of malignancy (6.4%) were reported. In postmenopausal age group, most frequent finding in DUB was complex hyperplasia seen in 8 cases (33.3%), out of which 2 cases showed atypia. Six cases (25%) of simple hyperplasia and 4 cases (16.7%) of malignancy were reported. Atrophic endometrium was observed in D&C samples from 6 patients (25%).

Morphological Spectrum of Endometrium in Patients Presenting with Dysfunc- tional Uterine Bleeding

Human cysticercosis is an infection by the larval stage of the tapeworm. We encountered a rare case of isolated cysticercosis of sternocleidomastoid muscle in a 25 year old female. She presented with 2.5 × 1.5 cm firm, dull aching swelling with ill defined margins in right upper part of neck. It appeared to arise in sternocleidomastoid muscle. The diagnosis was established by FNAC, USG and CT scan. Patient was admitted and started on medical treatment. There was complete resolution of symptoms and patient improved to normal after 1 month of therapy with albendazole. The case is reported because it is a rare one and to reinforce the fact that parasitic etiology should be kept in mind while dealing with a case of neck swelling.

/pdf/isolated-cysticercosis-cellulosae-of-sternocleidomastoid-2qhu58dmvb.pdf

Isolated cysticercosis cellulosae of sternocleidomastoid muscle: a case report with review of literature.

Heterotopic pancreatic tissue in the gallbladder is a very uncommon lesion, which is an incidental finding in most cases. We report here, a case of an 18-year-old, post puerperal female, suffering from right upper quadrant abdominal pain with a clinical diagnosis of chronic cholecystitis, in whom heterotopic pancreatic tissue was found in the gall bladder.

Heterotopic pancreas in gall bladder associated with chronic cholecystolithiasis

Lymphadenopathy is a rare mode of presentation of cysticercus infestation. Hence, in endemic areas, cysticercosis must be included in the differential diagnosis of superficial palpable swellings in the neck region. We report two cases of cervical lymphadenopathy which were clinically suspected to be of tuberculous etiology. However, fine-needle aspiration cytology (FNAC) revealed features of parasitic lymphadenitis consistent with cysticercosis. Our cases highlight the importance of FNAC as an initial and rapid diagnostic modality for detecting parasitic lesions manifesting as lymphadenitis. Diagnosis by the minimally invasive FNA technique prompted an early therapeutic intervention with good response in our patients.

/pdf/cysticercosis-presenting-as-cervical-lymphadenopathy-a-rare-uw8dso5fku.pdf

Cysticercosis presenting as cervical lymphadenopathy: a rare presentation in two cases with review of literature.

Cymbopogon martinii, commonly known as palmarosa, is an essential oil-bearing crop cultivated by the farmers for production of oil used in perfumery, cosmetics and flavour industries. The study on the economics of palmarosa cultivation has shown that the major portion of operational cost was shared by human labour, distillation charges and preparation of nursery. Total variable cost was found to be 47926 per hectare per year. The gross returns were found to be 124000 per hectare per year. The net returns over variable cost were 76074 per hectare. The benefit–cost ratio was found to be 2.59 indicating a higher profit to the farmers. The independent variables like human labour, planting material and distillation charges were positive indicating significant impact on the returns from the crop. There is need for effective market intelligence system to ensure remunerative price of the produce to the farmers.

http://staff.cimap.res.in/PublicationFiles/Indian_J._Agri.Research.pdf

Rani Bansal

Papers

Morphological Spectrum of Endometrium in Patients Presenting with Dysfunc- tional Uterine Bleeding

Isolated cysticercosis cellulosae of sternocleidomastoid muscle: a case report with review of literature.

Heterotopic pancreas in gall bladder associated with chronic cholecystolithiasis

Cysticercosis presenting as cervical lymphadenopathy: a rare presentation in two cases with review of literature.

Economic analysis of palmarosa cultivation in india