Histopathological Findings in Postmenopausal Bleeding

A Lakhey, Anamika Priyadarsinee, Samikchya Regmi, Sneh Acharya
In: Med Phoenix · 2023 · vol. 8(1) , pp. 48–52 · doi:10.3126/medphoenix.v8i1.56924 · W4385424716
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This retrospective cross-sectional study analyzed 270 endometrial and endocervical biopsy samples from patients presenting with postmenopausal bleeding to identify histological patterns across different age groups. The results indicated that benign conditions, particularly endometrial hyperplasia, were the most frequent findings, although malignancies such as endometrial and cervical carcinomas accounted for a significant portion of cases. Adenomyosis was identified as one of several benign discoveries among the cohort, alongside leiomyoma and endometritis, highlighting the diverse etiologies associated with this clinical presentation. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Introduction: Postmenopausal bleeding is commonly considered a significant and alarming indicator of genital diseases. The term "postmenopausal bleeding" typically refers to uterine bleeding. Since it is a sign of many different etiologies and has a strong correlation with malignancy and conditions with substantial morbidity and mortality, prompt identification and treatment are desired for postmenopausal bleeding. Materials and Methods: It is a retrospective cross-sectional observational study carried out in the pathology division of KIST Medical College and Hospital, Lalitpur, Nepal. From July 2017 to July 2022, 270 endometrial and endocervical biopsy samples with a history of postmenopausal bleeding were included. Following microscopic analysis, frequencies of histological findings in various age groups were generated. To determine whether the difference was significant, chi-square and proportions were used; the cutoff value was set at p 0.05. Results: On average, the patients were 51.9 years old, plus or minus 6.6 years. Of the 270 samples included, 222 (82.2%) were endometrial biopsies, and the remaining samples were cervical biopsies. Endometrial hyperplasia was the most common histological finding overall, occurring in 67 (24.8%) of the patients. With a mean age of 65.33 years, endometrial and cervical cancer patients were between the ages of 51 and 79. Endometrial and cervical carcinomas were together present in 31 (11.48%) of the patients. Leiomyoma was one discovery; others included endometritis, adenomyosis, endometrial polyps, hormonal deviations, and disordered proliferative endometrium. Endometrial hyperplasia was discovered in 20 patients over the age of 50 and 47 patients under the age of 50; this finding is statistically significant at a p-value of 0.05. Conclusion: In postmenopausal bleeding, benign diseases predominated, but the proportion of endometrial and cervical cancers and pre-malignant disorders was rather high. Our study demonstrates the significance of the endometrial sample, particularly in peri/postmenopausal women who have atypical uterine bleeding.
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Keywords

Cervical Carcinoma, Endometrial Carcinoma, Endometrial Hyperplasia, Endometrial Sampling, Postmenopausal BleedingAbstract

Introduction

Postmenopausal bleeding is commonly considered a significant and alarming indicator of genital diseases. The term "postmenopausal bleeding" typically refers to uterine bleeding. Since it is a sign of many different etiologies and has a strong correlation with malignancy and conditions with substantial morbidity and mortality, prompt identification and treatment are desired for postmenopausal bleeding.

Materials and methods

It is a retrospective cross-sectional observational study carried out in the pathology division of KIST Medical College and Hospital, Lalitpur, Nepal. From July 2017 to July 2022, 270 endometrial and endocervical biopsy samples with a history of postmenopausal bleeding were included. Following microscopic analysis, frequencies of histological findings in various age groups were generated. To determine whether the difference was significant, chi-square and proportions were used; the cutoff value was set at p 0.05.

Results

On average, the patients were 51.9 years old, plus or minus 6.6 years. Of the 270 samples included, 222 (82.2%) were endometrial biopsies, and the remaining samples were cervical biopsies. Endometrial hyperplasia was the most common histological finding overall, occurring in 67 (24.8%) of the patients. With a mean age of 65.33 years, endometrial and cervical cancer patients were between the ages of 51 and 79. Endometrial and cervical carcinomas were together present in 31 (11.48%) of the patients. Leiomyoma was one discovery; others included endometritis, adenomyosis, endometrial polyps, hormonal deviations, and disordered proliferative endometrium. Endometrial hyperplasia was discovered in 20 patients over the age of 50 and 47 patients under the age of 50; this finding is statistically significant at a p-value of 0.05.

Conclusion

In postmenopausal bleeding, benign diseases predominated, but the proportion of endometrial and cervical cancers and pre-malignant disorders was rather high. Our study demonstrates the significance of the endometrial sample, particularly in peri/postmenopausal women who have atypical uterine bleeding. Downloads Published How to Cite Issue Section License Copyright (c) 2023 Med Phoenix This work is licensed under a Creative Commons Attribution 4.0 International License. This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. Copyright on any research article is transferred in full to MED PHOENIX upon publication. The copyright transfer includes the right to reproduce and distribute the article in any form of reproduction (printing, electronic media or any other form).

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