Introduction
Postmenopausal bleeding is bleeding from the reproductive system that occurs one year after menstrual periods have stopped. Bleeding from the genital tract occurring after the menopause is much more sinister than premenopausal bleeding. The main objectives in the diagnostic workup in postmenopausal women presenting with uterine bleeding is to detect or rule out endometrial cancer or atypical hyperplasia, further referred to as (pre) malignancy of the endometrium. Aims and Objectives: 1. To determine the causes of postmenopausal bleeding from endometrial histopathology. 2. To correlate between the histopathological report of endometrial biopsy and surgical specimen. 3. To evaluate the relation between age, parity, post-menopausal bleeding duration, endometrial thickness, uterine size, body mass index, and medical disorders in women presenting with postmenopausal bleeding versus the risk of endometrial hyperplasia and cancer. Methodology: This is a study, on histopathology of endometrium in postmenopausal bleeding women and its clinical correlation, undertaken in the department of obstetrics& gynecology over a period of 6 months. Results: 30 women presented with PMB out of which 3 were endometrial cancer, 13 cases were EH without atypia, 9 cases were EH with atypia and 5 cases of endometrial atrophy. Conclusion: In my study positive correlation was found with risk factors, in women with premalignant and malignant lesions.
Introduction
Postmenopausal bleeding is bleeding from the reproductive system that occurs one year after menstrual periods have stopped. Bleeding from the genital tract occurring after the menopause is much more sinister than premenopausal bleeding. The main objectives in the diagnostic workup in postmenopausal women presenting with uterine bleeding is to detect or rule out endometrial cancer or atypical hyperplasia, further referred to as (pre) malignancy of the endometrium. Aims and Objectives: 1. To determine the causes of postmenopausal bleeding from endometrial histopathology. 2. To correlate between the histopathological report of endometrial biopsy and surgical specimen. 3. To evaluate the relation between age, parity, post-menopausal bleeding duration, endometrial thickness, uterine size, body mass index, and medical disorders in women presenting with postmenopausal bleeding versus the risk of endometrial hyperplasia and cancer. Methodology: This is a study, on histopathology of endometrium in postmenopausal bleeding women and its clinical correlation, undertaken in the department of obstetrics& gynecology over a period of 6 months. Results: 30 women presented with PMB out of which 3 were endometrial cancer, 13 cases were EH without atypia, 9 cases were EH with atypia and 5 cases of endometrial atrophy. Conclusion: In my study positive correlation was found with risk factors, in women with premalignant and malignant lesions.
Files
IJPCR,Vol16,Issue11,Article177.pdf
Files
(362.0 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:32bf50cbc699412eb16f9e49df114e1b
|
362.0 kB | Preview Download |
Additional details
Dates
- Accepted
-
2024-10-26
Software
- Repository URL
- http://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue11,Article177.pdf
- Development Status
- Active
References
- 1. Begum J, Samal R. A Clinicopathological Evaluation of Postmenopausal Bleeding and Its Correlation with Risk Factors for Developing Endometrial Hyperplasia and Cancer: A Hospital-Based Prospective Study. J Midlife Health. 2019 Oct-Dec; 10(4):179-183. doi: 10.4103/jmh.JMH_136_18. PMID: 31942153; PMCID: PMC6947719. 2. Singh G, Cue L, Puckett Y. Endometrial Hyperplasia. [Updated 2024 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NB K560693/ 3. Zhang L, Guo Y, Qian G, Su T, Xu H. Value of endometrial thickness for the detection of endometrial cancer and atypical hyperplasia in asymptomatic postmenopausal women. BMC Womens Health. 2022 Dec 12; 22(1):517. doi: 10.1186/s12905-022-02089-y. PMID: 3651021 3; PMCID: PMC9743752. 4. Sung S, Carlson K, Abramovitz A. Postmenopausal Bleeding. [Updated 2023 Dec 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NB K562188/ 5. Talwar S, Kaur H, Tapasvi I, Nibhoria S, Tapasvi C. Clinical and Histopathological Characteristics in Women With Postmenopausal Bleeding: A Study of 120 Women in a Tertiary Care Hospital in Punjab. Cureus. 2024 Jan 5; 16(1):e51690. doi: 10.7759/cureus.51690. PMI D: 38313886; PMCID: PMC10838394. 6. Jo HC, Baek JC, Park JE, Park JK, Cho IA, Choi WJ, Sung JH. Clinicopathologic Characteristics and Causes of Postmenopausal Bleeding in Older Patients. Ann Geriatr Med Res. 2018 Dec; 22(4):189-193. doi: 10.4235/agmr. 18.0042. Epub 2018 Dec 31. PMID: 3274 3272; PMCID: PMC7387628. 7. Passarello K, Kurian S, Villanueva V. Endometrial Cancer: An Overview of Pathophysiology, Management, and Care. Semin Oncol Nurs. 2019 Apr; 35(2):157-165. doi: 10.1016/ j.soncn.2019.02.002. Epub 2019 Mar 11. PMID: 30867105. 8. Mahdy H, Casey MJ, Vadakekut ES, et al. Endometrial Cancer. [Updated 2024 Apr 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NB K525981/ 9. Raychaudhuri G, Bandyopadhyay A, Sarkar D, Mandal S, Mondal S, Mitra PK. Endometrial hyperplasia: a clinicopathological study in a tertiary care hospital. J Obstet Gynaecol India. 2013 Dec; 63(6):394-8. doi: 10.1007/s13224- 013-0414-2. Epub 2013 Jun 27. PMID: 244316 86; PMCID: PMC3889273. 10. Gale A, Dey P. Postmenopausal bleeding. Menopause Int. 2009 Dec; 15(4):160-4. doi: 10.1258/mi.2009.009039. PMID: 19933468. 11. Nees LK, Heublein S, Steinmacher S, JuhaszBöss I, Brucker S, Tempfer CB, Wallwiener M. Endometrial hyperplasia as a risk factor of endometrial cancer. Arch Gynecol Obstet. 2022 Aug; 306(2):407-421. doi: 10.1007/s00 404-021-06380-5. Epub 2022 Jan 10. PMID: 35001185; PMCID: PMC9349105. 12. Alcázar JL, Bonilla L, Marucco J, Padilla AI, Chacón E, Manzour N, Salas A. Risk of endometrial cancer and endometrial hyperplasia with atypia in asymptomatic postmenopausal women with endometrial thickness ≥11 mm: A systematic review and meta-analysis. J Clin Ultrasound. 2018 Nov; 46(9):565-570. doi: 10.1002/jcu.22631. Epub 2018 Aug 16. PMID: 30113073.13. Ryu KJ, Kim MS, Lee JY, Nam S, Jeong HG, Kim T, Park H. Risk of Endometrial Polyps, Hyperplasia, Carcinoma, and Uterine Cancer After Tamoxifen Treatment in Premenopausal Women With Breast Cancer. JAMA Netw Open. 2022 Nov 1; 5(11):e2243951. doi: 10.1 001/jamanetworkopen.2022.43951. PMID: 364 41547; PMCID: PMC9706361. 14. Clarke MA, Long BJ, Sherman ME, Lemens MA, Podratz KC, Hopkins MR, Ahlberg LJ, Mc Guire LJ, Laughlin-Tommaso SK, Bakkum-Gamez JN, Wentzensen N. Risk assessment of endometrial cancer and endometrial intraepithelial neoplasia in women with abnormal bleeding and implications for clinical management algorithms. Am J Obstet Gynecol. 2020 Oct; 223(4):549.e1-549.e13. doi: 10.1016/j.ajog.2020.03.032. Epub 2020 Apr 5. PMID: 32268124; PMCID: PMC7529796. 15. Furness S, Roberts H, Marjoribanks J, Lethaby A. Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. Cochrane Database Syst Rev. 2012 Aug 15; 2012(8):CD000402. doi: 10.1002/14651858. CD00 0402.pub4. PMID: 22895916; PMCID: PMC7039145.