A critical appraisal of the spectrum of polypoidal lesions of uterus: A pathologists’ perspective

Abstract

Background: Polypoidal lesions of the uterus are clinically significant as they may either clinically mimic or harbour endometrial hyperplasia or malignancy. Material & Methods: A retrospective analysis was conducted over a three period (2012-2015) for all the polypoidal lesions of the uterus. All the clinical details of the patients, that is, age, menopausal status, obstetric history, signs and symptoms, co-morbidities like diabetes mellitus (DM) and hypertension, size of the polyp, its location in uterus and final histopathological diagnosis were recorded and analysed. Immunohistochemistry was performed wherever required. Pathological spectrum of polypoidal lesions, the incidence of premalignancy and malignancy as well as correlation with other clinicopathological parameters was evaluated. Results: Out of a total of 44 polypoidal lesions, 37(84.09%) were benign, 11.36% were hyperplastic/ premalignant while only 2 polypoidal lesions (4.54%) were malignant. Out of 37 patients with benign polyps (group 1), 4 were diabetic while 4 out of 7 patients with premalignant and malignant polyps (group 2) were diabetic, the difference being statistically significant. There were no significant differences in age, polyp size, parity, menopausal status and hypertension between the two groups. Conclusions: Although the sample size of the study was small, based on our observations, we wish to reemphasize the importance of careful histopathological scrutiny of all uterine polypoidal lesions to rule out any premalignant or malignant focus. Moreover, diabetics with uterine polyps should be cautiously handled as DM was significantly associated with incidence of premalignant/ malignant lesion.

Keywords

• Polyps
• endometrial
• polypoidal lesions
• uterus
• malignancy
• hyperplasia