Study of spectrum of endometrial pathology in patients with abnormal uterine bleeding and its clinicopathological correlation

Abstract

Background: The term abnormal uterine bleeding (AUB) is defined as any bleeding from uterus not fulfilling the criteria of normal uterine bleeding in terms of frequency, duration and amount. AUB is one of the most common complaints in gynaecological OPDs resulting in endometrial sampling. Material and methods: The present study was conducted in SHKM Government Medical College Nalhar, Nuh, Haryana from January 2018 to November 2019 by Departments of Pathology and Gynaecology. One hundred eighty cases of AUB were included in the study. Endometrial samples such as endometrial biopsy, dilatation and curettage material (D&C), fractional curettage specimens and hysterectomy specimens were included in the study. Gross and microscopic features were studied. Results: The age group of patients in this study ranged from 20 to 67 years. Maximum numbers of cases (n=90) were in the age group of 40 to 49 years. Most common presenting complaint was menorrhagia (50.5%). Normal cyclical endometrium was found to be the commonest histopathological pattern with proliferative endometrium in 48.8% and secretory endometrium in 22.2% cases. On histopathology rest of the cases revealed disordered proliferative phase in 20(11.1%) cases, endometrial hyperplasia in 2(1.1%), chronic endometritis in 8(4.4%), granulomatous inflammation in 2(0.01%), senile cystic atrophy in 6(3.3%) and malignancy in 4(2.2%) cases. Conclusion: Disordered proliferative phase endometrium, hyperplasia and carcinoma endometrium are seen more commonly in perimenopausal and postmenopausal females. Hence, histopathological 3 examination should be considered mandatory in women above 40 years of age presenting with AUB to rule out any malignant pathology.