Histopathological Pattern of Endometrial Sampling Performed for Abnormal Uterine Bleeding
01 Jan 2011-
TL;DR: It is revealed that secretory and proliferative endometrium are the most common endometrial histopathological patterns identified in endometrian samples obtained for abnormal uterine bleeding in the authors' region.
Abstract: Result: The commonest histopathological diagnosis was secretory endometrium 571 (24.9%), followed by proliferative endometrium 498 (21.7%), endometrial polyp 227 (9.9%), disordered proliferative endometrium 200 (8.7%), simple cystic hyperplasia 160 (7%), chronic endometritis 134 (5.8%), inactive endometrium 126 (5.5%), atrophic endometrium 70 (3.1%), uterine malignancies 41 (1.8%), complex hyperplasia without atypia 33 (1.4%) and finally complex hyperplasia with atypia 15 (0.7%). Two hundred twenty (9.6%) revealed no endometrial tissue and were considered insufficient for diagnosis. Uterine malignancies and complex hyperplasia with atypia were more common in the age group of 52 years and older, 3.3% and 1.2% respectively. Conclusion: The present study revealed that secretory and proliferative endometrium are the most common endometrial histopathological patterns identified in endometrial samples obtained for abnormal uterine bleeding in our region.
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01 Jan 2013
TL;DR: Endometrial curetting and biopsy is an important diagnostic procedure in evaluation of AUB, therefore it is specially recommended in women of the perimenopausal age presenting with AUB to rule out preneoplasia and malignancy.
Abstract: 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.
60 citations
Cites result from "Histopathological Pattern of Endome..."
...7%cases of proliferative endometrium [8]....
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...1% [8] in other studies, however our results were less as compared to 48....
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...A favourable comparison can be drawn with other studies in literature [8,6,21]....
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...Majority of the studies have observed an increased incidence similar to our findings in the perimenopausal age group [6-8]....
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Journal Article•
TL;DR: 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.
Abstract: 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.
57 citations
01 Jul 2012
TL;DR: In postmenopausal age group, most frequent finding in DUB was complex hyperplasia seen in 8 cases, out of which 2 cases showed atypia, which was higher than in perimenopausa l age group.
Abstract: 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%).
43 citations
Cites background from "Histopathological Pattern of Endome..."
...Abdullah & Bondagji (2011) analysed 2295 endometrial samples from women presenting with abnormal uterine bleeding from January 1995 to June 2008 and noted that commonest histopathological diagnosis was secretory endometr ium in 571 (24.9%)cases,followed by proliferative endometrium in 498 (21.7%),…...
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TL;DR: 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 and it will help in further management.
Abstract: 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.
32 citations
TL;DR: The proliferative endometrium and secretoryEndometrium were the most common histopathological observations in AUB patients in the authors' region, and except normal endometrial, disordered proliferative Endometrium was the mostcommon cause of AUB.
Abstract: The aim of this study was to assess the frequency of different histopathological findings obtained from dilatation and curettage (D&C) specimens in patients with abnormal uterine bleeding (AUB). In a retrospective review of 591 specimens, the included subjects were all women with AUB who underwent D&C between 2002 and 2006 in Be’sat Hospital, Tehran, Iran. The pathological diagnoses were analyzed in four groups from normal to malignant endometrium. The pathological groups were evaluated for patients’ characteristics including demographic data and medical history. The majority of patients (61.6 %) were in the 41–50 year age group. Totally, 81.4 % of patients had normal pathology. The disordered proliferative endometrium/polyps, hyperplasia, and malignant pathology were found in 15.4, 2.5, and 0.7 % of specimens, respectively. The abnormal pathologies were seen more among patients with postmenopausal status, nulli-/primigravid women, and those with hypertension, diabetes, hypothyroidism, and polycystic ovary syndrome. The proliferative endometrium and secretory endometrium were the most common histopathological observations in AUB patients in our region, and except normal endometrium, disordered proliferative endometrium was the most common cause of AUB.
24 citations
References
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TL;DR: Age, menopause status, and hypertension may increase the risk of premalignant and malignant polyps and operative hysteroscopy should be offered to symptomatic patients or to patients with risk factors.
270 citations
TL;DR: Investigation of endometrial histopathology in a geographically defined population of women presenting with postmenopausal bleeding finds no significant differences between menopausal and non-menopausal women.
221 citations
TL;DR: Estimating age-specific incidence of endometrial hyperplasia in women aged 18-90 years at a large integrated health plan found that simple, complex, and atypicalhyperplasia peaks in the early postmenopausal years and in theEarly 60s, respectively.
157 citations
TL;DR: Hypertension associated with obesity appears to be an important factor in combination which may play role in the pathogenesis of EPs like the late menopause which was noted in 30% of examined postmenopausal women.
Abstract: Objectives Endometrial polyps (EPs) are among the common cases of abnormal uterine bleeding. Hormonal factors may be involved in the pathogenesis as indicated by endometrial abnormalities in patients treated with tamoxifen. This study was designed to analyse the patient characteristics which may be associated with polyp occurrence and assess the diagnostic and therapeutic difficulties. Group of 245 patients was formed to 152 postmenopausal and 93 premenopausal women with EP diagnosed hysteroscopically and confirmed histologically. Evaluated factors were as follows: 1) patient characteristics: age, body mass, systemic hypertension, diabetes mellitus, nulliparity, late menopause, estrogen replacement therapy, and tamoxifen treatment; 2) clinical features of EPs, and 3) the number of curettage's (D & C) and hysteroscopies. Results Hypertension associated with obesity appears to be an important factor in combination which may play role in the pathogenesis of EPs like the late menopause which was noted in 30% of examined postmenopausal women. An association between EPs and tamoxifen was found in 8% patients with breast cancer. 2. Postmenopausal uterine bleeding and menstrual disorders were prominent clinical symptoms in 44% post- and in 82% of premenopausal women. The other 56% post- and 18% premenopausal patients were asymptomatic. 3. The multiple EPs were present in 26% of postmenopausal and in 15% premenopausal women. 4. Transvaginal ultrasonography supplemented by sonohysterography in cases with abnormal ultrasonographic findings should be the main diagnostic method. 5 Hysteroscopical polypectomy is regarded as the optimal therapy and the removal of the endometrial basalis in the EP origin area prevents persistence or recurrence of EP.
105 citations
Journal Article•
TL;DR: A study of endometrial polyps in biopsy specimens of symptomatic women showed 311 cases in a population of 1305 patients, an incidence of 23.8%, with the highest incidence seen in the fifth decade of life and after menopause.
93 citations