Histopathological Spectrum of Endometrium in Hysterectomy Specimens from Cases of Abnormal Uterine Bleeding

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This retrospective study analyzed the histopathological spectrum of endometrial changes in 150 hysterectomy specimens from women presenting with abnormal uterine bleeding. The results indicated that benign conditions were the most prevalent findings, with endometrial hyperplasia accounting for 30% of cases and chronic endometritis comprising 25%. Other notable diagnoses included leiomyomas in 20% of patients, while premalignant atypical hyperplasia and malignant endometrial carcinoma were observed in 10% and 5% of cases, respectively. Benign entities such as endometrial polyps and adenomyosis were each present in 10% of the examined specimens. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Background: Abnormal uterine bleeding (AUB) is a common gynecological issue leading to significant morbidity in women of reproductive and postmenopausal age. Histopathological examination of endometrial tissue obtained from hysterectomy specimens provides essential insights into the underlying causes of AUB. This study aims to analyze the histopathological spectrum of endometrial changes in hysterectomy specimens from patients presenting with AUB. Materials and Methods: A retrospective study was conducted on hysterectomy specimens from 150 women with AUB, collected over a period of One year. Patient demographic data, clinical presentation, and histopathological findings were recorded and analyzed. Specimens were fixed in formalin, processed, and stained with hematoxylin and eosin. The histopathological diagnosis was categorized into benign, premalignant, and malignant lesions. Results: Out of 150 cases, 60% were in the age group of 41-50 years. The most common histopathological finding was endometrial hyperplasia (30%), followed by chronic endometritis (25%) and leiomyomas (20%). Premalignant lesions such as atypical hyperplasia were observed in 10% of cases, while endometrial carcinoma was found in 5% of cases. Benign conditions like endometrial polyps and adenomyosis were present in 10% of the specimens. Conclusion: The histopathological spectrum of the endometrium in hysterectomy specimens from AUB cases is diverse, with benign lesions being the most common. Endometrial hyperplasia and chronic endometritis are significant contributors to AUB. The detection of premalignant and malignant lesions highlights the importance of histopathological examination in the management of AUB.
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Background

Abnormal uterine bleeding (AUB) is a common gynecological issue leading to significant morbidity in women of reproductive and postmenopausal age. Histopathological examination of endometrial tissue obtained from hysterectomy specimens provides essential insights into the underlying causes of AUB. This study aims to analyze the histopathological spectrum of endometrial changes in hysterectomy specimens from patients presenting with AUB. Materials and Methods: A retrospective study was conducted on hysterectomy specimens from 150 women with AUB, collected over a period of One year. Patient demographic data, clinical presentation, and histopathological findings were recorded and analyzed. Specimens were fixed in formalin, processed, and stained with hematoxylin and eosin. The histopathological diagnosis was categorized into benign, premalignant, and malignant lesions. Results: Out of 150 cases, 60% were in the age group of 41-50 years. The most common histopathological finding was endometrial hyperplasia (30%), followed by chronic endometritis (25%) and leiomyomas (20%). Premalignant lesions such as atypical hyperplasia were observed in 10% of cases, while endometrial carcinoma was found in 5% of cases. Benign conditions like endometrial polyps and adenomyosis were present in 10% of the specimens. Conclusion: The histopathological spectrum of the endometrium in hysterectomy specimens from AUB cases is diverse, with benign lesions being the most common. Endometrial hyperplasia and chronic endometritis are significant contributors to AUB. The detection of premalignant and malignant lesions highlights the importance of histopathological examination in the management of AUB.

Abstract

(English)

Background

Abnormal uterine bleeding (AUB) is a common gynecological issue leading to significant morbidity in women of reproductive and postmenopausal age. Histopathological examination of endometrial tissue obtained from hysterectomy specimens provides essential insights into the underlying causes of AUB. This study aims to analyze the histopathological spectrum of endometrial changes in hysterectomy specimens from patients presenting with AUB. Materials and Methods: A retrospective study was conducted on hysterectomy specimens from 150 women with AUB, collected over a period of One year. Patient demographic data, clinical presentation, and histopathological findings were recorded and analyzed. Specimens were fixed in formalin, processed, and stained with hematoxylin and eosin. The histopathological diagnosis was categorized into benign, premalignant, and malignant lesions. Results: Out of 150 cases, 60% were in the age group of 41-50 years. The most common histopathological finding was endometrial hyperplasia (30%), followed by chronic endometritis (25%) and leiomyomas (20%). Premalignant lesions such as atypical hyperplasia were observed in 10% of cases, while endometrial carcinoma was found in 5% of cases. Benign conditions like endometrial polyps and adenomyosis were present in 10% of the specimens. Conclusion: The histopathological spectrum of the endometrium in hysterectomy specimens from AUB cases is diverse, with benign lesions being the most common. Endometrial hyperplasia and chronic endometritis are significant contributors to AUB. The detection of premalignant and malignant lesions highlights the importance of histopathological examination in the management of AUB. Files IJTPR,Vol14,Issue8,Article26.pdf Files (292.7 kB) | Name | Size | Download all | |---|---|---| | md5:e27f923a8c0c01cb334cbe8d46086902 | 292.7 kB | Preview Download | Additional details Dates - Accepted - 2024-07-26 Software

References

- 1. Munro MG, Critchley HO, Fraser IS. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011; 95(7):2204-2208. 2. Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison KH. Incidence of endometrial hyperplasia. Am J Obstet Gynecol. 2009; 200(6):678.e1-6. 3. Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon: IARC Press; 2014. 4. Greenbaum AR, Rice CL, Harris MB, Rossman KM, Ochoa JJ. Chronic endometritis: clinical characteristics and treatment. Int J Gynecol Obstet. 2001; 73(3):257-262. 5. Stewart EA. Uterine fibroids. Lancet. 2001; 357(9252):293-298.6. Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health. 2012; 12:6. 7. Trimble CL, Kauderer J, Zaino R, Silverberg S, Lim PC, Burke JJ, et al. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a GOG 210 study. J Clin Oncol. 2006; 24(15):2799-2803. 8. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019; 69(1):7-34. 9. Lee SC, Kaunitz AM, Sanchez-Ramos L, Rhatigan RM. The oncogenic potential of endometrial polyps: a systematic review and meta-analysis. Obstet Gynecol. 2010; 116(5):1197-1205. 10. Vercellini P, Viganò P, Somigliana E, Fedele L. Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynaecol. 2006; 20(4):465-477.

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