Abstract
Background: Endometrial hyperplasia (EH) is considered a heterogeneous pre-neoplastic clinical entity characterized by an abnormal glandular proliferation, with less than half of the tissue area occupied by the stroma. The aim of this retrospective study was to evaluate the correlation between the histological diagnosis of atypical endometrial hyperplasia (AEH) obtained through office hysteroscopy (OH) or uterine dilation and curettage (D&C) and the definitive histological evaluation after hysterectomy. Methods: Among 112 patients with atypical EH, 45 (40%) underwent hysteroscopy and 67 (60%) curettage. Results: The diagnostic accuracy of OH was very high: in particular, it showed a diagnostic coincidence in 87% of cases with the definitive histological diagnosis through hysteroscopy. The curettage, instead, had diagnostic coincidence only in 14% of cases. Conclusion: Office hysteroscopy is the ideal procedure for both diagnosis and follow-up of endometrial hyperplasia.
Highlights
Endometrial hyperplasia (EH) is usually detected after investigation of perimenopausal women with abnormal uterine bleeding
Specificity, PPV, NPV, of the histological evaluation of atypical EH obtained by office hysteroscopy (OH) or dilation and curettage (D&C) and the definitive histological diagnosis performed after hysterectomy (Table 5)
Among 112 patients with atypical EH, 45 (40%) underwent hysteroscopy and 67 (60%) curettage. Among these 112 women, 80 underwent hysterectomy; while among the 32 patients who were not operated, 8 women with mean age of 35 years (25–39) (7.1%) opted for a narrow follow-up by ultrasound every 6 months and hysteroscopy every year, and 10 of them (8.9%) underwent hysteroscopic resection of focal endometrial hyperplastic areas or endometrial polyps placed in atypical hyperplastic areas
Summary
Endometrial hyperplasia (EH) is usually detected after investigation of perimenopausal women with abnormal uterine bleeding It is defined as an excessive proliferation of glands of irregular size and shape with an increase in the glands/stroma ratio [1]. In premenopausal women with abnormal uterine bleeding, the incidence of EH has been reported to be as high as 10% [4]. Endometrial hyperplasia (EH) is considered a heterogeneous pre-neoplastic clinical entity characterized by an abnormal glandular proliferation, with less than half of the tissue area occupied by the stroma The aim of this retrospective study was to evaluate the correlation between the histological diagnosis of atypical endometrial hyperplasia (AEH) obtained through office hysteroscopy (OH) or uterine dilation and curettage (D&C) and the definitive histological evaluation after hysterectomy. Conclusion: Office hysteroscopy is the ideal procedure for both diagnosis and follow-up of endometrial hyperplasia
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