Histopathological Pattern of Endometrial Abnormalities in Postmenopausal Women With Abnormal Uterine Bleeding

Sana  Naveed; Amna  Jahan; Muhammad Naeem  Raza

doi:10.54112/bcsrj.v6i4.1685

Authors

Sana Naveed Department of Pathology, Services Hospital/Services Institute of Medical Sciences Lahore, Pakistan
Amna Jahan Department of Pathology, Services Hospital/Services Institute of Medical Sciences Lahore, Pakistan
Muhammad Naeem Raza Department of Neurosurgery, Punjab institute of Neurosciences Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i4.1685

Keywords:

Postmenopausal women, abnormal uterine bleeding, endometrial abnormalities, histopathological patterns, endometrial carcinoma

Abstract

Abnormal uterine bleeding (AUB) in postmenopausal women often warrants prompt evaluation due to the risk of underlying malignancy or premalignant conditions. Histopathological examination of endometrial tissue remains a definitive diagnostic approach for identifying the etiology of AUB in this population. Objective: To assess the histopathological patterns of endometrial abnormalities in postmenopausal women presenting with abnormal uterine bleeding (AUB). Methodology: One hundred and forty five postmenopausal women aged ≥50 years with confirmed AUB were selected for this study. Non-endometrial causes of bleeding which were myometrial lesions, intrauterine devices, pregnancy-related complications, or hormone therapy were not included. Endometrial biopsies were obtained which were fixed in 10% formalin and processed for histopathological examination using hematoxylin-eosin staining. Histological findings were categorized as benign polyps, hyperplasia (with/without atypia), carcinoma, atrophic, proliferative, or secretory endometrium, and chronic endometritis. Results: Mean age was 55.19 ± 1.72 years. Atrophic endometrium was found in 32.4% patients, hyperplasia without atypia in 25.5%, secretory endometrium in 11.0%, and hyperplasia with atypia in 9.7% patients. Endometrial carcinoma was observed in 3.4% patients. Benign polyps and chronic endometritis were observed in 6.2% and 6.9% patients respectively. Conclusion: Atrophic endometrium was the leading pattern in postmenopausal women with abnormal uterine bleeding which was followed by hyperplasia without atypia and secretory endometrium.

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References

Lebduska E, Beshear D, Spataro BM. Abnormal uterine bleeding. Med Clin. 2023;107(2):235-46.

Wouk N, Helton M. Abnormal Uterine Bleeding in Premenopausal Women. Am Fam Physician. 2019;99(7):435-43.

Leal CRV, Vannuccini S, Jain V, Dolmans MM, Di Spiezio Sardo A, Al-Hendy A, Reis FM. Abnormal uterine bleeding: The well-known and the hidden face. J Endometr Uterine Disord. 2024

Marnach ML, Laughlin-Tommaso SK. Evaluation and Management of Abnormal Uterine Bleeding. Mayo Clin Proc. 2019;94(2):326-35.

Munro MG, Critchley HOD, Fraser IS., FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393-408.

Trinder J, Brocklehurst P, Porter R, Read M, Vyas S, Smith L. Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial). BMJ. 2006;332(7552):1235-40.

Barnhart KT, Katz I, Hummel A, Gracia CR. Presumed diagnosis of ectopic pregnancy. Obstet Gynecol. 2002;100(3):505-10.

Farquhar CM, Lethaby A, Sowter M, Verry J, Baranyai J. An evaluation of risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding. Am J Obstet Gynecol. 1999;181(3):525-9.

Singh S, Best C, Dunn S, Leyland N, Wolfman WL. No. 292-Abnormal uterine bleeding in pre-menopausal women. J Obstet Gynaecol Canada. 2018;40(5):e391-415.

Kafle N, Shaukin S, Kafle SU, Singh M, Parajuli SB. Histopathological pattern of endometrial biopsies in patients with abnormal uterine bleeding attending Birat medical college teaching hospital. Birat J Health Sci. 2020;5(2):1035-9.

Lata G, Sharma S, Kaur SP, Gulia SP. Histopathological pattern of endometrial biopsy in females with abnormal uterine bleeding: a retrospective study in tertiary care hospital of Haryana. Int J Reprod Contracept Obstet Gynecol. 2020;9(10):4068-74.

Chauhan S, Radhakrishnan K. Clinical profile of endometrial histopathological patterns in Abnormal Uterine Bleeding. Nepal J Obstet Gynaecol. 2020;15(1):50-4.

Xue H. Shen W-J, Zhang Y. Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometriurn. World J Clinic Cases. 2022;10(7):2159.

Husain S, Al Hammad RS, Alduhaysh AK, AlBatly MM, Alrikabi A. Pathological spectrum of endometrial biopsies in Saudi women with abnormal uterine bleeding: A retrospective study of 13-years. Saudi Med J. 2021; 42(3): 270-9.

Aston B, Weaver R. Risks and benefits of hysteroscopy and endometrial sampling as a standard procedure for assessing serendipitous findings of endometrial thickening in postmenopausal women. Aust N Z J Obstet Gynaecol. 2014;54(6):597-9.

Elfayomy AK, Habib FA, Alkabalawy MA. Role of hysteroscopy in the detection of endometrial pathologies in women presenting with postmenopausal bleeding and thickened endometrium. Arch Gynecol Obstet. 2012;285:839-43.

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):1197-205.

Kaleem S, Arif A, Hamdani SNR, Syed FN, Afzal K, Saddique S. Histopathological spectrum of endometrium in peri-menopausal and postmenopausal women in Southern Punjab; An experience at tertiary care hospital. Pak J Pathol. 2021;32(2):52-5.