Clinico-Radiological and Histopathological Study of Endometrial Lesions in Patients Presenting with Abnormal Uterine Bleeding

Abstract

Background: Abnormal uterine bleeding [AUB] is one of the most common presentations among women of all age groups. It is ‘Bleeding from the uterine corpus that is abnormal in volume, regularity or timing for the majority of last 6 months. Common pathologies include hormonal imbalance patterns, atrophic endometrium, endometritis, endometrial polyp, endometrial hyperplasia and endometrial carcinoma. Material & Methods: All specimens of endometrial curettage, biopsy and hysterectomy received in department of pathology GMC, Haldwani from January 2020 to September 2021 , have been included in the study. Specimens were fixed in 10% formalin and processed routinely. Clinical details and endometrial thickness by ultrasonography were recorded and analysed. Microscopic examination was performed after routine and special stains. Results: Out of a total of 103 cases, abnormal uterine bleeding was frequently observed in the age group 40 – 49 years, followed by 50 – 59 years. Most common presenting complaint was menorrhagia followed by post menopausal bleeding. Most common histopathological finding was proliferative phase endometrium followed by secretory phase endometrium. The range of endometrial thickness recorded in the proliferative phase was mostly 4-9 mm followed by the secretory phase with 9 – 15 mm. Two cases of endometrial carcinoma were seen after 5th decade onward. All cases of endometrial hyperplasia and carcinoma had an endometrial thickness of more than 15 mm. Conclusion: AUB may be the only presenting complaint in patients with malignant or pre-malignant endometrial lesions. Histopathology helps to reach a definitive diagnosis crucial for management. Keywords: Abnormal uterine bleeding, Endometrial sampling, Endometrial thickness, Endometrial hyperplasia, Endometrial carcinoma