Endometrium In Abnormal Uterine Bleeding Research Articles

Histopathological study of endometrium in abnormal uterine bleeding with expression of oestrogen and progesterone receptors

Histopathological study of endometrium in abnormal uterine bleeding with expression of oestrogen and progesterone receptors

CLINICO-HISTOPATHOLOGICAL STUDY OF ENDOMETRIUM WITH AND WITHOUT HORMONE THERAPY IN PATIENTS WITHABNORMAL UTERINE BLEEDING

Background: Abnormal uterine bleeding (AUB) is one of the most common problem for the patients and the gynecologists. Histological characteristics of endometrial biopsy material as assessed by light microscopy remains the diagnostic standard for the diagnosis of endometrial pathology. Material and Methods: In our prospective study of 100 patients of the age between 24-75 years, clinical characteristics and the pattern of endometrial histopathology and their association with hormone therapy administration were studied. Results: Total of 100 patients were divided into two subgroups one that received hormone therapy prior to endometrial biopsy and Group II in which hormone therapy was not administered prior to the said procedure. In both groups proliferative phase was the commonest followed by secretory endometrium in both groups. Pill change, Arias Stella reaction, tubercular endometritis, endometrial carcinoma was exclusively noted in the group in hormone therapy was administered prior to endometrial biopsy. Pill change endometrium was only significantly correlated with Group I (p=0.05). Simple hyperplasia, endometrial polyp, chronic endometritis, endocervical polyp, atrophic endometrium was noted in Group II of which simple hyperplasia (p=0.10) was not found to be clinically significant. Conclusions: The study of the endometrium in AUB revealed many structural and non-structural causes manifest in the form of different endometrial histopathological patterns in two groups with or without hormone therapy. Endometrial study gives significant etiological information in AUB when interpreted with relevance to age and other clinical data, thus guiding the appropriate management.

Clinicopathological study of 400 endometrial curettage samples at rural tertiary care centre

Introduction: An endometrial sampling procedure is a gold standard for the diagnostic evaluation of women with abnormal uterine bleeding (AUB) with primary aim to identify the cause, especially to determine whether carcinoma or premalignant lesions are present. Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology outpatient department. Here we are presenting a study of 400 endometrial curettage samples with regard to the clinic-pathological findings. Objectives: This study was done to evaluate 400 endometrial curettage samples clinicopathologically at a rural tertiary care centre. Material and Methods: A total of 400 endometrial curettage samples were processed and H & E staining was done. Special staining and IHC was done wherever required. Clinicopathological correlation was done in all the cases and the results are compared to other studies. Results: In our study of 400 endometrial curettage samples, the minimum age observed was 18 years and maximum age of 70 years with most common age group was between 31-40 years. The commonest findings were of cyclical changes in the endometrium followed by abnormal endometrial pathology and trophoblastic diseases. Conclusion: Endometrial biopsy is an important tool to diagnose gynaecological conditions in patients. It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. Postmenopausal bleeding should be considered as an indication of malignancy until proved otherwise.

HISTOPATHOLOGICAL STUDY OF ENDOMETRIUM IN WOMEN WITH ABNORMAL UTERINE BLEEDING

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.

Cliniopathological profile in women with abnormal uterine bleeding

Introduction: Abnormal uterine bleeding is a challenging gynecological problem caused by various endometrial pathologies and is a major clinical problem among women in peri and postmenopausal age groups. The problem is common worldwide but causes may vary from one region to another. Aims and Objectives: The main objective was to evaluate pathological spectrum of different endometrial lesions in abnormal uterine bleeding and to correlate with clinical history and diagnosis. Materials and Methods: The study was a prospective study done from August 2017 to July 2019. The specimens received from endometrial biopsy were included in the study. All the specimens were fixed in formalin and processed through paraffin wax embedding method. Sections were cut at 3-5 micrometer thickness and stained by Hematoxylin and Eosin (H&E) stain and were examined under light microscope. Result: A total no. of 247 cases were studied. Out of these, 57 cases were of Proliferative endometrium, 33 cases of Secretory endometrium, 34 cases of simple hyperplasia without atypia, 11 cases of cystic glandular hyperplasia, 17 cases of complex hyperplasia with atypia, 09 cases of menstrual phase endometrium, 07 cases of irregular shedding, 06 cases of endometrial polyp and anovulatory cycle, 04 cases of endometritis, 03 cases each of simple hyperplasia with atypia, progesterone exposed endometrium and inadequate secretory phase, 02 cases each of complex hyperplasia without atypia, atrophic endometrium, products of conception and inadequate proliferative phase and 01 case each of stromal hyperplasia. 45 samples were inadequate. Maximum cases of abnormal uterine bleeding were seen between 31-40 years of age. Interpretation and Conclusion: Abnormal uterine bleeding is one of the commonest condition for which patients seek advice in the gynecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know th

Study of endometrium in abnormal uterine bleeding at Patan Academy of Health Sciences, Patan Hospital Nepal

Introduction:Abnormal uterine bleeding (AUB) is considered as one of the most common and challenging problem presenting to the gynecologist. Establishing a cause of AUB is important, as medical therapy is effective in managing abnormal bleeding in most cases and should be attempted prior to surgical management. Endometrial biopsy is a safe and effective diagnostic step in evaluation of endometrium after ruling out any medical causes. The objective of this study is to evaluate the different histopathological patterns of the endometrial biopsy specimens in women presenting with AUBat Patan Hospital.
 Method: A two year retrospective study of AUB covering the year 2068 to 2069 . Patients charts were retrieved from the medical record section and reviewed.
 Result: The most common age group presenting with AUB was 41–50 years 58(49.1%).Among these patients,normal physiological patterns 62 (52.5%) with secretory endometrium(24.6%), proliferative endometrium 29 (22.9%) and menstrual phase 6 (5.1%) were observed. The commonest pathology irrespective of the age group was disordered proliferative pattern 23 (19.5%). Othercauses identified were endocervical polyp 8 (6.8%), hormonal effect 5 (4.2%), atrophic endometrium 5 (4.2%),endometrial carcinomas 5 (4.2%), complications of pregnancy 3 (2.5%), endometrial hyperplasias 3 (2.5%), endometritis 3 (2.5%) and endometrial polyp 1 (0.8%).
 Conclusion:Histopathological variations of the endometrium can detect the cause of the disorders taking into account the age and phase of a menstrual cycle. Timely evaluation of AUB by histopathology can be life saving diagnostic tool for early management.

A study of histomorphological patterns of endometrium in abnormal uterine bleeding

Abnormal uterine bleeding(AUB) is one of the most common gynaecological problems, which accounts for about 33% of out patient referrals. It is a debilitating condition with high direct and indirect costs. AUB is considered as a cause of significant health care burden for women, their families and society as a whole. To study the various histomorphological patterns of endometrium in AUB. This is a retrospective study done in Department of Pathology, tertiary care hospital, JJMMC Davangere for a period of 2 years from January 2016 to December 2017. 212 cases of endometrial biopsies were reviewed in AUB. The slides were obtained from departmental archives and clinical data from the histopathological forms. The data was entered and interpreted in Microsoft Excel and the analysis was done in percentages and proportions and was represented in tables, graphs and pie charts wherever necessary. A total of 212 cases were analysed and the age of females ranged from 20-62 yrs. The most common histomorphological pattern was Endometrial Hyperplasia without atypia in 43.0% of cases followed by Secretory endometrium in 15.6% of cases. Proliferative endometrium was seen in 14.6% of cases and Disordered proliferative endometrium was seen in 14.2% of cases. There were also 2 cases with Simple atypical hyperplasia. The cause of AUB can be identified by the histopathological study of endometrial curettages and biopsies. This helps to plan for successful management of the females presenting with AUB.

Histopathological study of endometrium in abnormal uterine bleeding

Histopathological study of endometrium in abnormal uterine bleeding

A Study of Histopathological Analysis of Endometrium in Abnormal Uterine Bleeding in a Tertiary Care Centre

A Study of Histopathological Analysis of Endometrium in Abnormal Uterine Bleeding in a Tertiary Care Centre

Histopathological study of endometrium in abnormal uterine bleeding in perimenopausal and postmenopausal women

Background: Abnormal uterine bleeding (AUB) is defined as any change in the frequency of menstruation, duration of flow, or amount of blood loss. Histopathological study of endometrium gives valuable information to arrive at correct diagnosis. Objective: The study was aimed to detect the frequency of various pathological conditions which can cause AUB in perimenopausal and postmenopausal women and to know the distribution of functional changes as well as malignancy causing AUB. Materials and Methods: This is a retrospective study on 200 patients of perimenopausal and postmenopausal women who presented with AUB from May 2016 to May 2018 (2 years), selected on the basis of simple random sampling. Histopathological study was done on the specimens for diagnostic and therapeutic purposes. Histomorphological details were recorded as per standard pro forma along with clinical and other details and entered on a master chart. A statistical analysis was done to record the frequency of distribution and mean of various parameters. Results: Out of 200 cases, the most common histopathological finding was proliferative phase in 65 cases (42.4%), followed by disordered proliferation in 46 cases (30%). Primary endometrioid adenocarcinoma comprised only 6 cases (3%). Conclusion: The most common endometrial pathology found in our study was functional endometrial changes, and the occurrence of malignancy increased with the increasing age of patients.

Clinicopathological Evaluation of Abnormal Uterine Bleeding with Special Reference to Estrogen Receptor (ER), Progesterone Receptor (PR)2 and HER-2 / NEU Status

Background: Abnormal Uterine Bleeding (AUB) may be defined as any variation from normal menstrual cycle including alteration in its regularity, frequency, duration of flow and amount of blood loss. AUB can present as menorrhoea, metrorrhagia, poly menorrhoea and dysfunctional uterine bleeding. The study aimed to found out the various aetiopathological factors responsible for AUB. To correlate clinical presentation with histopathological examination and also to study the hormone receptor markers ER (Estrogen Receptors), PR (Progesterone receptor) and marker of oncogene HER-2/NEU for prognostication. Methods: This study was conducted during the period Sept. 2012 to January 2015 in the Department of Obstetrics and Gynecology in collaboration with Dept. of Pathology, Hi-Tech Medical College, Bhubaneswar. 140 patients of 15-55 yrs of age groups were randomly selected excluding pregnant patients and patients below 15 yrs and above 55 yrs. All patients were subjected to Transvaginal-ultransonography, saline infusion sonography and dilation and curettage (D&C) along with endometrial biopsy. All histopathological samples were stained with Hematoxylin and Eosin stain (H&E stain) and subsequently immunostaining was done for ER, PR and HER-2 / NEU. Result: 37.20% cases of AUB were observed in the age group of 41-45. 0.7% among age group of 51-55 yrs. 64.3% of rural population & 67.2% of patients from lower socio-economic group had AUB. 48.6% cases presented with menorrhagia and 42.9% cases had etiological features of dysfunctional uterine bleeding (DUB), 20% had endometrial polyp and 14 cases out of 140 had endometrial carcinoma. In the present study ER were positive in 84.7% and PR were positive in 76.7%. HER-2/NEU expression in this study showed different histopathological pattern of endometrium in AUB. The present study also showed HER-2/NEU expression in 21.4% cases of different grades of Endometrial Carcinoma and all DUB cases showed negative HER-2 / NEU expression. Conclusion: In this study clinical presentation, use of different diagnostic modalities and histopathological correlation were reviewed. Large number of patients belonged to age group 41-50 yrs. The incidence of AUB was maximum in rural areas and most patients belong to lower socio-economic group. By use of Hormone receptors expression of ER & PR and observing the over expression of HER-2 / NEU the prognosis of endometrial lesions can be assessed for early and proper management.

Histopathological Study of Endometrium in Abnormal Uterine Bleeding in Reference to Different Age Groups, Parity and Patterns of bleeding

Histopathological Study of Endometrium in Abnormal Uterine Bleeding in Reference to Different Age Groups, Parity and Patterns of bleeding

Diagnostic utility of histopathological patterns of endometrium in abnormal uterine bleeding and its correlation with age -a two years study at a rural Tertiary care hospital in south india

Diagnostic utility of histopathological patterns of endometrium in abnormal uterine bleeding and its correlation with age -a two years study at a rural Tertiary care hospital in south india

Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Introduction: Endometrial specimen for abnormal uterine bleeding (AUB) is the one of the commonest specimens received in histopathology laboratory. Histopathological characteristics of endometrial tissues, as assessed by light microscopy, remains the diagnostic standard for the management of AUB. The objective of study is to find out the histopathological pattern of endometrium in AUB in the light of clinical details.
 
 Methods: This was a prospective observational study carried out in the department of Pathology, Lumbini Medical College Teaching Hospital for a period of two years from June 2014 to May 2016. Formalin fixed endometrial specimens were processed, paraffin embedded, sectioned at 3-4 µm, stained with hematoxylin and eosin, and studied under light microscopy along with their demographics. Data were collected, entered and analyzed using SPSS version 20.
 
 Results: The study included 100 cases of endometrial biopsy specimens with clinical diagnosis of AUB. Menstrual disturbances was found in wide age range between 17-75 years with the mean age of 45 (SD=13.36) years. Menorrhagia was the commonest (n=60, 60%) clinical presentation. Most (n=85; 85 %) endometrium had non-neoplastic lesions. Among them, normal endometrial patterns were commonest (n=50, 50 %). Neoplastic lesions (n=15, 15%) were distributed in all menstruation status with majority in postmenopause (n=7, 7%) and included malignant cases (n=5, 5%) among others.
 
 Conclusion: Post-menopausal bleeding was common presentation among women with malignant and premalignant disease which was present in 15% of the cases together. Timely evaluation of AUB by histopathology can be life saving with early tissue diagnosis and management.

Study of histopathological patterns of endometrium in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a common gynecological complaint associated with considerable morbidity and significantly affects the patient's family, personal and social life. The aim of the study was to analyze the histomorphological patterns of endometrium in patients presenting with AUB and also to determine the incidence of AUB in various age groups. Materials and Methods: This is a prospective study, conducted in the Department of Pathology, in a tertiary care teaching hospital, Mangalore from October 2011 till date. All cases of AUB with a probable endometrial cause were included in the study. Data was entered in Microsoft Excel and managed in Statistical Package for the Social Sciences (SPSS) version 16. Analysis was done in the form of percentages and proportions and represented as tables where necessary. Results: A total of 156 cases were analyzed. Patients' age ranged from 23-78 years. AUB was most prevalent in the perimenopausal age group. The most common presenting complaint was menorrhagia (47%). Endometrial hyperplasia was the most common histopathological finding and was seen in 25% patients, followed by secretory endometrium in 16.7% patients, and proliferative phase pattern and disordered proliferative endometrium were seen in 12.2% patients each. Malignancy was detected in 6.4% of cases and endometrial carcinoma was the most common lesion (4.5%). Conclusions: Histopathological evaluation of endometrial samples is especially indicated in women over the age of 35 years to rule out malignancy and preneoplasia. Among the patients with no organic pathology, normal physiological patterns with proliferative, secretory, and menstrual changes were observed. The most common endometrial pathology in this series was endometrial hyperplasia.

Correlation between cytological and histopathological examination of the endometrium in abnormal uterine bleeding.

Background:Abnormal uterine bleeding (AUB) is a common problem for which women seek gynecological consultation. Endometrial aspiration cytology (EAC) is an acceptable and valuable diagnostic procedure for screening the endometrial status.Materials and Methods:Endometrial aspiration using a menstrual regulation (MR) syringe and a 4 mm Karman's cannula was performed just prior to D and C in 100 women presenting with AUB. Smears were reviewed for cytomorphological findings and were correlated with the histopathological findings. These findings were categorized as benign endometrium, endometrial hyperplasia, malignancy and inadequate smears.Results:Age of the patients ranged from 19 to 70 years. In our study, the accuracy in diagnosing benign conditions of endometrium, hyperplasia, and malignancy on aspiration cytology were 93.88%, 96.94% and 96.84%, respectively.Conclusions:Endometrial aspiration is an effective, useful and a minimally invasive procedure. With an experienced cytologist, it can be used routinely for the primary investigation of women with AUB, provided all the points of discrepancies are taken care of.

Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study

Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. 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 peri-menopausal (40-49 years) and post-menopausal (> 50 years) age group. 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 post-menopausal bleeding (26.05%). In peri-menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endometrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post-menopausal age group. Three cases of endometrial carcinoma were reported in post-menopausal age group only. 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.

Histopathological study of endometrium in abnormal uterine bleeding

Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features.Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied.Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%).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.Journal of Pathology of Nepal (2012) Vol. 2, 297-300DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882

Evaluation of the endometrium in abnormal uterine bleeding associated with long-term tamoxifen use

Objective To evaluate the underlying endometrial pathology in breast cancer patients receiving long-term tamoxifen and presenting with abnormal bleeding. Design Prospective cohort study (1996–97). Setting Minimal access surgical training centre in a large teaching hospital. Methods Outpatient ultrasound scan, hysteroscopy and endometrial sampling were carried out in 24 breast cancer patients with abnormal uterine bleeding who were receiving tamoxifen. If these outpatient procedures failed, inpatient hysteroscopy and endometrial sampling was undertaken. On diagnosis of an endometrial polyp, inpatient hysteroscopy, polypectomy and curettage were carried out. Results Hysteroscopy revealed polyps in 17 of 24 patients (71%). Histologically, 13 polyps were benign, three polyps had hyperplasia (one simple and two complex), and one polyp was malignant. Endometrial thickness (ET) on ultrasound scan was associated with hyperplasia or cancer only at ET ≥ 10 mm. Conclusion In breast cancer patients receiving tamoxifen and presenting with abnormal bleeding, a high rate of pathological endometrial lesions was observed. All the polyps were diagnosed hysteroscopically but prediction of premalignant/malignant lesions, which were confirmed by histological assessment, could not be done hysteroscopically. There is a need to assess the accuracy, acceptability and cost-effectiveness of the various tests for evaluating endometrial pathology.

Histopathological pattern of endometrial samples in abnormal uterine bleeding

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16