Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Abstract

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.

Review of histopathologic findings of endometrial biopsy done at a tertiary referral hospital in urban Ethiopia

“…In the current study TB endometritis was detected in 3(1.08%) which was lower than the prevalence from the study in India, showing cases of tuberculous endometritis in 3(3%) (17), but comparable to studies in Nigeria and Ethiopia in which histological examination identified 3(0.9%) and 2(1.3%) of endometrial tuberculosis respectively(14, 18).…”

Histopathology of Endometrial Biopsies in Cases of Abnormal Uterine Bleeding- A Four Year Study

“…Six cases were classical endometrioid adenocarcinoma and villoglandular variants and three were endometrioid carcinoma with squamous differentiation. Tiwari et al [12] showed a similar incidence of 5%.…”

Histopathological evaluation of endometrium and its clinical correlation in patients of abnormal uterine bleeding

“…Similar age distribution was seen in study done by Tiwari et al in Nepal showed premenopausal women were 60%, perimenopausal were 23% and 17% were postmenopausal. 21 Out of 366 cases, 276 (75%) cases had non neoplastic lesions and 90 (25%) had neoplastic lesions, normal endometrial pattern (61%) was most frequent finding out of nonneoplastic lesions. Tiwari et al also found same as our study, non neoplastic lesions were in 85% cases and neoplastic in 15% cases and out of nonneoplastic normal endometrial pattern was most common (50%).…”

“…Tiwari et al also found same as our study, non neoplastic lesions were in 85% cases and neoplastic in 15% cases and out of nonneoplastic normal endometrial pattern was most common (50%). 21 Both had proliferative phase most common in normal pattern. The bleeding in proliferative phase may be due to anovulatory cycles and in secretory phase due to ovulatory dysfunctional uterine bleeding.…”

“…In present study, disordered proliferative pattern was seen in 6% of cases, incidence is lower as compared to results shown by Tiwari et al (19%). 21 A disordered proliferative endometrium term is used for proliferative endometrium that does not seem appropriate for any one time in the menstrual cycle and mimic simple hyperplasia but changes are focal rather than diffuse. It represents earliest stage of endometrial carcinoma spectrum and detection of disease at this stage help in prevention of disease progression.…”