HISTOPATHOLOGICAL SPECTRUM OF ENDOMETRIAL LESIONS IN PATIENTS WITH ABNORMAL UTERINE BLEEDING

Saad Masood, Muhammad Tahir Khadim, Syed Salman Ali

Abstract


Objective: To determine pattern of different endometrial lesions in patients presenting with abnormal uterine bleeding.

Study design: Descriptive, cross sectional study.

Place & duration of study: Department of Pathology Combined Military Hospital, Multan, from 4th May 2016 to 4th November 2016.

Materials and Methods: A total of 150 cases of endometrial curettings and endometrial biopsies were included in the study. Sample size was calculated using WHO sample size calculator. The patients were selected by non-probability, consecutive sampling technique, who presented with abnormal uterine bleeding, for a duration of more than 3 months, between 30 to 60 years of age. Patients with pregnancy and pregnancy related conditions, history of chronic heart disease or any malignancy and bleeding disorders like coagulopathy or hemophilia were not included in the study. The specimens was fixed in 10 % buffered formalin, grossed and stained with Hematoxylin and Eosin to examine morphology. The morphology was reviewed by a histopathologist who has more than 5 years of experience after post-graduation to establish diagnosis.

Results: Our study included a total of 150 study cases having abnormal uterine bleeding meeting inclusion criteria of our study. Mean age of our study cases was 46.44 ± 6.49 years. Our study results have indicated that majority of our patients i.e. 102 (68%) were aged 46 – 60 years. Majority of our study cases i.e. 92 % were married and only 8 % patients were un – married. Mean disease duration was 4.33 ± 1.07 months and majority of our patients i.e. 108 (72%) presented with disease duration of 3 – 5 months. Proliferative phase endometrium was observed in 16.7%, secretory phase in 22 (14.7%), disordered proliferative endometrium in 16%, atrophic endometrium in 3.3%, chronic endometritis in 16 %, endometrial polyps in 8.7%, endometrial hyperplasia in 12%, endometrial carcinoma in 2%, hormone induced changes in 9.3% and squamous metaplasia in 1.3% of our study cases.

Conclusion: Proliferative endometrium was predominantly more common followed by chronic endometritis and secretory phase in our study. Disordered proliferative endometrium and endometrial polyp showed significant association with marital status. Prolonged disease duration was associated with disordered proliferative endometrium, endometrial polyps and endometrial hyperplasia. Atrophic endometrium was seen in reproductive age group. Finally, endometrial hyperplasia and endometrial carcinoma were significantly associated with increasing age.

Key words: Abnormal uterine bleeding, endometrium, histopathological pattern.

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