Histomorphological patterns of endometrium in abnormal uterine bleeding

Roopmala Murugan, Thamilselvi Ramachandran, Poovizhi Inbasekaran

Abstract


Background: Abnormal uterine bleeding (AUB) is a common gynecological complaint, for which histopathological examination of endometrium is the gold standard tool in diagnostics. Aim of this study is to analyze various histomorphological patterns of endometrium in patients belonging to various age groups with abnormal uterine bleeding. Materials and Methods: A retrospective study of 174 patients presenting with abnormal uterine bleeding underwent endometrial sampling during a period of 2 years from September 2017 to August 2019 at VMKVMCH, Department of Pathology, were analyzed. Endometrial tissue received by sampling procedures such as dilatation and curettage (D & C), endometrial biopsy and fractional curettage were all submitted entirely for processing in the Department of Pathology. Patient data were collected, and slides were reviewed. Result: A total of 174 cases were analyzed. Patients’ age ranged from 15 to 65 years. The predominant endometrial finding was proliferative endometrium 54 cases (31%) followed by secretory endometrium 50 cases (28.7%). Malignant lesions were seen in 5 cases (2.87%) in patients more than 49 years of age. Among the organic causes, polyps were the commonest 8 cases (4.59%). Adequate samples were obtained from 91% of cases while 9% of cases’ samples were inadequate for opinion. Conclusion: Histopathological examination of endometrial samples should be done in patients with abnormal uterine bleeding, especially in women over 35 years of age to rule out malignancy and preneoplasia. Patients with no organic pathology had normal physiological patterns like proliferative endometrium, secretory endometrium and menstrual changes. Most common endometrial pathology in this series was endometrial polyp 8 cases (4.59%).

Full Text:

PDF

References


Chitra T, Manjani S, Madhumittha R, Harke AB, Saravanan E, Karthik S. Histopathology of endometrial curettings in perimenopausal women with abnormal uterine bleeding. J. Evolution Med. Dent. Sci.2016;5 (24): 1285-1290. doi: 10.14260/jemds/2016/301

Mazur M, Kurman RJ. Diagnosis of endometrial biopsies and curettings: a practical approach. Springer Science & Business Media; 2005.

Jetley S, Rana S, Jairajpuri ZS. Morphological spectrum of endometrial pathology in middle-aged women with atypical uterine bleeding: A study of 219 cases.J Midlife Health. 2013;4(4):216-220. doi: 10.4103 /0976-7800.122242

Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding. J Pathol Nepal. 2012;2(4):297-300. doi: https://doi.org/ 10.3126 /jpn.v2i4.6882

Sajitha K, Padma SK, Shetty KJ, Prasad HLK, Permi HS, Hegde P. Study of histopathological patterns of endometrium in abnormal uterine bleeding. Chris Med J Health Res. 2014;1(2):76-81. doi: 10.4103/2348-3334. 134265.

Azim P, Mumtaz MK, Sharif N, Khattak E. Evaluation of abnormal uterine bleeding on endometrial biopsies. Isra Med J. 2011;3(3):84-87.

Khan S, Hameed S, Umber A. Histopathological pattern of endometrium on diagnostic D & C in patients with abnormal uterine bleeding. Ann King Edward Med Univers. 2011;17(2):166. doi: https://doi.org/10.21649/ akemu. v17i2.293

Bhosle A, Fonseca M. Evaluation and histo-pathological correlation of abnormal uterine bleeding in perimenopausal women. Bombay Hosp J. 2010;52 (1):69-72.

Puvitha RD, Elavarasan T, Shruthi MS, Shylaja S. Histopathological Study of Endometrium in Abnormal Uterine Bleeding. An Experience in a Tertiary Care Centre of Rural South India. Nat J Basic Med Sci. 2017;8:32-38.

Singh P. Abnormal Uterine Bleeding-evaluation by Endometrial Aspiration. J Mid-life Health. 2018; 9(1): 32-35. doi: 10.4103/jmh.JMH_109_17

Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynecol India. 2011; 61(4): 426-430. doi: 10.1007/ s13224-011-0047-2. Epub 2011 Sep 22.

Shajitha S., Sangeereni M, Mallika A. Study of endometrial pathology in abnormal uterine bleeding. Int J Curr Med Sci. 2017;7:324-326. doi: http://dx.doi.org/ 10.24327/ijcmes2017.07100025.

Abid M, Hashmi AA, Khan M. Clinical pattern and spectrum of endometrial pathologies in patients with abnormal uterine bleeding in Pakistan: need to adopt a more conservative approach to treatment. BMC Women’s Health. 2014;14:132. doi: 10.1186/s12905-014-0132-7

Mune SB, Karche AG. Histopathological patterns of endometrial lesions in patients with abnormal uterine Bleeding in rural area of Western Maharashtra. Indian J Pathol Oncol. 2016;3(4).665-672. doi: 10.5958/2394-6792. 2016.00124.1

Noyes RW, Hertig AT, Rock J. Dating the endo-metrial biopsy. Am J Obstet Gynecol. 1975;122 (2): 262-263. doi: https://doi.org/10.1016/S0002-9378(16) 33500-1


Refbacks

  • There are currently no refbacks.