HISTOPATHOLOGICAL STUDY OF ENDOMETRIUM IN WOMEN WITH ABNORMAL UTERINE BLEEDING

Abstract

BACKGROUND –Abnormal uterine bleeding (AUB) is dened as a bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle. The term dysfunctional uterine bleeding (DUB) is used to describe abnormal uterine bleeding for which no specic cause has been found. AUB is one of the most common gynaecological problems. This study was done to evaluate histological patterns of endometrium in women with abnormal uterine bleeding. AIMS AND OBJECTIVE – To study various histological patterns of endometrium in abnormal uterine bleeding and correlate it with age, parity and symptoms. MATERIAL AND METHODS –This is a retrospective study, conducted in the Department of Pathology, in a tertiary care hospital from 1st July 2016 to 30th June 2019. Total 718 specimens with AUB were included in the study from the age group of 21 to 95 years. The specimens received were hysterectomy (74.65 %), endometrial biopsies (21.45%), dilatation and curettage (2.79 %) and transcervical resection of endometrium (1.11 %). RESULTS –The patients with AUB were mainly from the age group 41-50 years with menorrhagia as the chief complaint. Most of the women with AUB were multiparous (84.54%). The most common pattern observed on histopathological examination was proliferative endometrium (49.86%) followed by atrophic endometrium (10.31%). Malignancy was found in 2.23% (Endometrioid carcinoma – 1.81%, serous carcinoma - 0.14% and mucinous carcinoma – 0.28%). Endometrial hyperplasia without atypia (23 cases, 3.20%) was more common than endometrial atypical hyperplasia (EAH) / endometrioid intraepithelial neoplasia {EIN} (4 cases, 0.56 %). Various other patterns of endometrium on histopathology were endometritis (6.82 %) followed by endometrial polyp (4.46 %). 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.