Stromal p16 expression differentiates endometrial polyp from endometrial hyperplasia

2012 ◽  
Vol 461 (2) ◽  
pp. 141-148 ◽  
Author(s):  
Suzuko Moritani ◽  
Shu Ichihara ◽  
Masaki Hasegawa ◽  
Akari Iwakoshi ◽  
Sakae Murakami ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Polyp ◽  
P16 Expression

scholarly journals Causes of Menorrhagia in Females Between 21-50 Years of Age Attending the Out Patient Department of Naseer Teaching Hospital

2015 ◽  
Vol 2 (1) ◽  
pp. 3-8
Author(s):  
Anjum Ara ◽  
Naheed Rahim
Keyword(s):  
Teaching Hospital ◽  
Endometrial Hyperplasia ◽  
Transvaginal Ultrasound ◽  
Case Series ◽  
Abdominal Ultrasound ◽  
Psychological Problem ◽  
Endometrial Polyp ◽  
Contraceptive Device ◽  
Fibroid Uterus ◽  
Case Series Study

OBJECTIVES:To determine the causes of menorrhagiaMATERIAL AND METHODS:This case series study was conducted in the department of obstetrics and Gyneacology Naseer Teaching Hospital Peshawar over a period of one year from June 2006 to May 2007. Eighty patients with menorrhagia were studied between ages of 21-50 years. All patients were thoroughly investigated for the causes of menorrhagia. All the patients having menstrual blood loss of more than eight days or history of passage of clots or having hemoglobin less than l0g/ dl were included in the study and patients having pubertal menorrhagia, less than 20 years of age or postmenopausal patients, on hormonal replacement therapy were excluded from the study.RESULTS:Out of total eighty patients, the commonest age group was above 40 years i.e.63.75% (n=51). The most common cause of menorrhagia was fibroid uterus in 47.5% (n=38) cases followed by adenomyosis in 25% (n=20) cases, endometrial polyp in 7.5% (n=6) cases, endometrial hyperplasia in 6.25% (n=5) cases, injectable progestogens in 6.25% (n=5) cases, intrauterine contraceptive device in 5% (n=4) cases. 30 patients (37.5%) were multipara, 25 (31.25%) were grand multipara and 25 (31.25%) were great grand multipara.All of them were anemic. Severe anemia (hemoglobin < 6 gm%) was found in one case (1.25%), moderate anemia (hemoglobin 6-8 gm%) in 45 cases (56.25%) and mild anemia (hemoglobin 8-10 gm%) in 34 cases (42.75%). Abdominal ultrasound alone was done in 63 cases (70.75%), and transvaginal ultrasound in 17 patients (21.25%). The diagnosis of fibroid uterus, endometrial polyp and endometrial hyperplasia was confirmed on ultrasound.CONCLUSION:In my study fibroid uterus (47.5%), adenomyosis (25%), endometrial polyp (7.5%) and endometrial hyperplasia (6.25%) were the common causes in patients presenting with menorrhagia to Naseer Teaching Hospital causing disruption and psychological problem for females.

scholarly journals Endometrial Metaplastic/Reactive Changes Coexistent with Endometrial Hyperplasia and Carcinoma: A Morphological and Immunohistochemical Study

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 63
Author(s):  
Antonio Travaglino ◽  
Frediano Inzani ◽  
Angela Santoro ◽  
Damiano Arciuolo ◽  
Alessia Piermattei ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Precancerous Lesions ◽  
Premalignant Lesions ◽  
Serous Carcinoma ◽  
Vimentin Expression ◽  
Ki67 Expression ◽  
Pten Loss ◽  
Nuclear Atypia ◽  
Reactive Changes ◽  
P16 Expression

The aim of this study was to assess the relationship between endometrial metaplastic/reactive changes (EMRCs) and endometrial neoplastic lesions. Twenty cases of “simple” (without architecture complexity) EMRCs coexistent with endometrial malignant/premalignant lesions, twenty cases of neoplasia-unassociated EMRCs, and eight cases of complex metaplastic lesions were assessed by immunohistochemistry. EMRCs coexisted with endometrioid carcinoma (n = 12), atypical endometrial hyperplasia (n = 3), serous carcinoma (n = 2), and clear cell carcinoma (n = 3). Neoplasia-associated EMRCs showed a mean Ki67 labeling index of 12.6% (range 0–30%); with nuclear atypia in 16/20 (80%) cases; diffuse p16 expression in 15/20 (75%) cases; and heterogeneous ER, PR, and vimentin expression. Compared to the associated neoplasia, EMRCs showed a lower Ki67 expression (p < 0.001) and higher p16 expression (p < 0.001). No EMRC case showed mitotic activity, PTEN loss, MMR deficiency, nuclear β-catenin, p53-mutant pattern, Napsin A, or AMACR expression. No significant differences were found between neoplasia-associated and neoplasia-unassociated EMRCs. Complex metaplastic lesions showed a lower Ki67 expression than EMRCs (p = 0.044) and PTEN loss in 5/8 cases, even in the absence of nuclear atypia. In conclusion, neoplasia-associated simple EMRCs may show evident atypia and a worrisome immunophenotype, but no data support their involvement in endometrial carcinogenesis. Architectural complexity appears as a crucial factor to identify precancerous lesions.

scholarly journals Endometrial biopsy is an important diagnostic tool for the evaluation of abnormal uterine bleeding

2021 ◽  
Vol 4 (1) ◽  
pp. 19-22
Author(s):  
Jaafar Makki ◽  
Ali hussein Al Khafaj
Keyword(s):  
Vaginal Bleeding ◽  
Endometrial Hyperplasia ◽  
Hydatidiform Mole ◽  
Endometrial Biopsy ◽  
Endometrial Polyp ◽  
Uterine Perforation ◽  
Organic Disease ◽  
Normal Endometrium ◽  
Chronic Endometritis ◽  
Abnormal Vaginal Bleeding

In this study 100 biopsies were taken from the endometrium of childbearing women (18-50 yrs. of age) suffering from abnormal vaginal bleeding from Jan 2019-Dec 2019. Endometrial Biopsy (EB) is safe, an outpatient procedure, low cost, carries out without general anesthesia & the incidence of hemorrhage, infection & uterine perforation are less common than with D&C. EB is an alternative to dilatation & curette (D&C) for the evaluation of infertile & abnormal vaginal bleeding or dysmenorrheic patients. There are two main groups of causes to irregular vaginal bleeding. 1. Organic disease (74% of the cases), in this group there are obvious lesion such as, endometrial polyp, endometrial hyperplasia & chronic endometritis. The most common cause was endometrial hyperplasia 48%, it is commonly seen during the perimenopausal period (40-50yr). Less common causes include chronic endometritis 8%, hydatidiform mole 7%, and endometrial polyp 7%. 2. non-organic disease comprises 19% of all cases, anovulatory period 13% or Luteal phase insufficiency 6%. They are commonly seen from age of 18-40yrs. 6% of the cases found to have normal endometrium. 5 endometrial biopsies were inadequate & unsatisfactory for histopathological interpretation. The aim of this study is to evaluate the usefulness & disadvantages of EB & to compare it with the traditional method of endometrial curette.

scholarly journals Evaluation of abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women

2017 ◽  
Vol 6 (8) ◽  
pp. 3607 ◽  
Author(s):  
Jaya Choudhary ◽  
Veena Acharya ◽  
Monika Jain
Keyword(s):  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Perimenopausal Women ◽  
Normal Menstrual Cycle ◽  
Group A ◽  
Sensitivity Specificity

Background: Abnormal uterine bleeding is defined as any deviation from the normal menstrual cycle this include change in regularity, frequency of menses, duration or amount of bleeding during or in between periods. Objective of present study was to evaluate abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women.Methods: This study is conducted on women presenting to the gynecological OPD with complain of abnormal uterine bleeding in perimenopausal age group. A total of 50 patients were subjected to transvaginal sonography and Diagnostic hysteroscopy.Results: On TVS, out of total 50 patients, 50% patient showed normal endometrial finding. 24% Patient showed Endometrial hyperplasia, 14% Endometrial Polyp, 8% Submucosal fibroid, 4% Adenomyosis. On TVS, out of total 50 patient, 50% patient showed normal endometrial finding. 24% Patient showed endometrial hyperplasia, 14% endometrial Polyp, 8% submucosal fibroid, 4% adenomyosis. Out of total 50 patients, 28 (56%) showed normal endometrial finding.20% cases showed endometrial Hyperplasia, 16% showed endometrial Polyp, 8% showed submucosal fibroid. Sensitivity, specificity, PPV, NPV of endometrial hyperplasia – 81.81%, 92.3%, 75%, 94.73% respectively.Conclusions: Transvaginal sonography has a moderate diagnostic accuracy in detecting endometrial hyperplasia and other intrauterine pathology. TVS is safe, acceptable and easily available & is noninvasive. It should be used as 1st line diagnostic tool in patients with AUB in perimenopausal women. Hysteroscopy has important tool in the diagnosis of various endometrial and intrauterine lesions TVS and hysteroscopy should be employed hand in hand in evaluation of AUB.

Hyperplastic processes of endometrium in women with infertility: comparing the results of ultrasonographic and pathomorphological changes of the endometrium

2018 ◽  
pp. 129-133
Author(s):  
Yu.I. Kuzyk ◽  
◽  
G.M. Chornenka ◽  
Keyword(s):  
Endometrial Hyperplasia ◽  
Color Doppler ◽  
Correct Diagnosis ◽  
Endometrial Biopsy ◽  
Reproductive Age ◽  
Endometrial Polyp ◽  
Ultrasound Diagnosis ◽  
Morphological Evidence ◽  
Endometrial Polyps ◽  
Stromal Component

The objective: to find out the level of verification of endometrial hyperplastic processes (GPE) in women with uterine infertility based on the comparison of ultrasound and pathomorphological studies. Materials and methods. 64 patients of reproductive age was performed ultrasonographic study and diagnostic endometrial biopsy. Results. Three groups of GPE have been identified: polyps – 33 cases, hyperplasia –15, combination of glandular hyperplasia with endometrial polyp – 16. The endometrial polyps included: glandular – seven cases, glandular-fibrous with an advantage of the glandular component – 13, and glandular-fibrous with the advantage of the stromal component – 13. The accuracy of the verification of glandular polyps was 82%. Glandular-fibrotic polyps with an advantage of the glandular component were diagnosed in 82%. Glandular-fibrous endometrial polyps with the advantage of the stromal component were the most difficult for ultrasonic verification. The accuracy of their diagnosis was 50%. Such characteristics as nodular form, intramural position, increased echogenicity and absence of inclusions were the basis for erroneous diagnosis of uterine fibromyomas. Endometrial hyperplasia was verified at 97%. The remaining 3% were histologically diagnosed with endometrial polyposis, which were not established by ultrasound, and were considered as hyperplasia of the endometrium. Ultrasound diagnosis of the combination of endometrial hyperplasia and polyps reached 77%. The polyps on the background of endometrial hyperplasia appeared as fibromyomatous nodes. The determining role in correct diagnosis was played by hysteroscopy. Conclusion. The comparison of ultrasound data and morphological evidence suggests high accuracy of GPE detection and morphological verification. However, in some cases GPE ultrasound does not precisely determine the nature of pathological changes. Therefore, the study of the pathomorphological features of remodeling of the endometrium in the GPE remains open and requires new promising approaches. One of them, based on certain pathomorphological changes in GPE, is the use of blood flow research, in particular transvaginal color doppler, which may allow to improve the accuracy of the diagnosis of GPE. Key words: endometrial hyperplasia, endometrial polyp, endometrial hyperplasia, ultrasound diagnosis, pathomorphology, reproductive age.

scholarly journals Transvaginal ultrasonography is the diagnostic method for evaluation of abnormal uterine bleeding

2012 ◽  
Vol 1 (1) ◽  
pp. 11-13
Author(s):  
Kulsum Haq ◽  
Shabnom Ferdous Chowdhury ◽  
Maksuda Mannan ◽  
Rokshana Ivy ◽  
K Shahneela Tasnim
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Transvaginal Ultrasonography ◽  
Transvaginal Sonography ◽  
Dysfunctional Uterine Bleeding ◽  
Histopathologic Evaluation

Objective: The objective of this study is to assess the utility of transvaginal ultrasonography in patients presenting abnormal uterine bleeding Materials and methods: Between July 2000 to December 2000, 50 patients underwent transvaginal sonography (TVS) for abnormal uterine bleeding. All patients had transvaginal sonography before histopathology. On TVS, the sonographic appearance of the endometrium was classified according to the following parameters: normal or abnormal thickness, homogeneous or heterogeneous echogenicity, bulbous contour, discontinuous, or obscured. A comparison was performed between TVS with histopathology. Results: The most common causes for the abnormal uterine bleeding were leiomyoma in TVS (42.0%). Other causes were dysfunctional uterine bleeding (28.0%). adenomyosis (6.0%), endometrial polyp (4.0%), thin atrophic endometrium (8.0%), endometrial hyperplasia (8.0%), and endometrial carcinoma (4.0%). After histopathologic evaluation 40.0% patients had leiomyoma, 24.0% DUB, 10.0% adenomyosis, 8.0% endometrial polyp, 8.0% thin atrophic endometrium, 6.0% endometrial carcinoma and 4.0% endometrial hyperplasia. Comparing the TVS with histopathologic findings, TVS had a sensitivity of 94.3%, specificity of 80.0%. accuracy of 90.0%, PPV of 91.6% and NPV of 85.7%. Conclusion: TVS is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in the diagnosis of uterine pathology responsible for abnormal uterine bleeding. Abbreviation: TVS transvaginal sonography; AUB abnormal uterine bleeding; DUB dysfunctional uterine bleeding, PPV positive predictive value, NPV Negative predictive value. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12168 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.11-13

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