Background: AUB is one of the most common problems in women of all ages especially those in the peri-menopausal age group. The abnormal bleeding can be caused by a wide variety of disorders and it is one of the commonest complaints leading to endometrial sampling. Objectives: Our study aimed at determining the types and frequencies of endometrial pathologies in patients presenting with abnormal uterine bleeding at our hospital which caters largely to women of low socioeconomic status. Material and Methods: The present study was conducted at the Hakeem Abdul Hameed Centenary Hospital, New Delhi. This was a retrospective age specific comparative analysis of 638 women presenting with abnormal uterine bleeding, who underwent endometrial sampling at our hospital. The pattern of endometrial histopathological changes were identified and classified. Results: Age of the patients ranged from 15 to 70 years, maximum patients (35.89 %) in the age group 41-50 years. The most common clinical presentation was represented by menorrhagia (41%) Various patterns on histopathology were secretory endometrium(28.99%)the commonest, followed by proliferative endometrium (24.92%). Incidence of malignancy was low in the present study. Conclusion: Endometrial curetting and biopsy is an important diagnostic procedure in evaluation of AUB.. Endometrial causes of AUB are age related, therefore it is specially recommended in women of the perimenopausal age presenting with AUB, to rule out preneoplasia and malignancy.

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Atypical uterine bleeding-Histopathological audit of endometrium A study of 638 cases

Background: Endometrial diseases ranked among the most common gynecological disorders that aff ect women globally. These diseases cut across all age groups and contribute signifi cantly to increased maternal morbidity and mortality. Due to the wide range of histopathological patterns, the need for urgent diagnosis and treatment cannot be overemphasized. Aim: The aim of this study is to highlight the frequency and histological types and patterns of the endometrial lesions in patients with abnormal uterine bleeding (AUB) in private practice in Benin-City, Nigeria. Materials and Methods: H and E stained-slides of endometrial biopsies diagnosed at the Ashamas foundation histopathology diagnostic center in Benin-City for 10 years were archived and studied. Request forms were analyzed for clinical bio-data, diagnosis and type of biopsies carried out. Data were entered using Micro-soft Excel package and transferred to statistics software (statistical package for the social sciences Version 17, SPSS Incorperated, Chicago Illinois, USA) for descriptive analysis. Results: In all, 231endometrial lesions were received. Of these, 207/231 (89.6%) cases were seen in reproductive and perimenopausal age groups while 24/231 (10.4%) was encountered in postmenopausal age group. The age range and peak age incidence was 17-86 years and fourth decade respectively. The mean age was 38.8 (6.8) years In all 231 endometrial lesions, product of conception was the most common fi nding observed (n=64/231; 27.7%) in reproductive and pre-menopausal women. While the most frequently encountered lesion in postmenopausal women was complex endometrial hyperplasia (n=6/231; 2.6%). Conclusion: Histopathological patterns of endometrial biopsy and curettage of women presenting with AUB is variable. Product of conception was the most commonly encountered among reproductive women. Nevertheless, endometrial hyperplasia was most frequent in perimenopausal age group.  Keywords: Cancer, endometrium, histopathology, lesions, private practice

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Histopathological patterns of endometrial lesions in patients with abnormal uterine bleeding in a cosmopolitan population

Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding.

Histopathological spectrum of endometrium in abnormal uterine bleeding

This study was conducted in 400 cases of endometrium in women of all age groups. The mean age of women presenting with abnormal uterine bleeding was 41 years. normal physiological changes of menstrual cycle, seen as proliferative and secretory phases of endometrium, were the most common histological findings present in 287 cases (71.75%). benign lesions were found in 19% cases followed by precursor lesions in 4.75% cases and malignant lesions in 4.5% cases. Histopathological examination of endometrial biopsy is a major diagnostic tool in evaluation of abnormal uterine bleeding (abnormal uterine bleeding) and a specific diagnosis could help the gynaecologist to plan therapy for successful management of abnormal uterine bleeding.

Histopathological study of endometrium in abnormal uterine bleeding in women of all age groups in western rajasthan (400 cases)

Introduction: Endometrial biopsies and curettings constitute an important tool for diagnosis of endometrial pathology; whether benign, pre-malignant and malignant, and help the gynecologist to decide appropriate therapeutic strategy. The present study was carried out to document the histopathological appearances seen in endometrial biopsies, and their age–wise distribution in patients with infertility and abnormal (irregular, excessive or continuous) uterine bleeding due to endometrial causes.
Materials and Methods: A total of 214 specimens of endometrial curettings and biopsies from patients with abnormal uterine bleeding due to endometrial causes and inability to conceive, received in the Pathology department, Gian Sagar Medical College and Hospital, Banur, Rajpura, over a period of two years from January 2012 upto December 2013, were retrieved and analyzed retrospectively, and their findings were documented. The tissue had been received in 10% formalin, processed routinely, and the slides had been stained with Hematoxylin and Eosin.
Results and Conclusion: The most common histopathological diagnosis was proliferative endometrium seen 33% cases. Products of conception were confirmed histologically in 12% cases. Endometrial hyperplasias were seen in 09% cases, and disordered proliferative endometrium in 06%. Secretory endometrium was seen in 07% cases. 02% biopsies showed atrophic endometrium. Luteal phase defects were seen in 07% of the specimens. 01% cases showed tubercular endometritis and adenocarcinoma each. The most common finding in patients of infertility was proliferative endometrium indicating anovulatory cycles.
Endometrial biopsy is a valuable tool in assessment of endometrial status in infertility, as well as benign and malignant pathology in abnormal uterine bleeding due to relative ease and accessibility of procedure and rapid availability of results.

Keywords: Abnormal uterine bleeding, Infertility, Dysfunctional uterine bleeding, Hyperplasia, Ca

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A two year histopathological study of endometrial biopsies in a teaching hospital in Northern India

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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S Lama

Papers

Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.