scholarly journals Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy

2014 ◽  
Vol 12 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Marco Antonio Lenci ◽  
Vanessa Alessandra Lui do Nascimento ◽  
Ana Beatriz Grandini ◽  
Walid Makin Fahmy ◽  
Daniella de Batista Depes ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Premalignant Lesions ◽  
Endometrial Polyps ◽  
Menstrual Status ◽  
Cellular Atypia ◽  
Malignant Lesions

Objective : To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy. Methods : The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.9%) patients were in menacme. Of the total, 193 (65.4%) presented abnormal uterine bleeding, and 102 (34.6%) were asymptomatic with altered endometrial echo on transvaginal ultrasound. Out of 725 (71.1%) postmenopausal patients, 171 (23.6%) were symptomatic (abnormal uterine bleeding), and 554 (76.4%) were asymptomatic with endometrial echo >5.0mm. Results : Twenty-one (2.0%) patients presented premalignant lesions in the polyps, 13 had simple glandular hyperplasia, of which 5 had no atypia, and eight presented atypia. Eight polyps presented focal area of complex hyperplasia: 4 with atypia and 4 without lesions. Cancer was diagnosed in 5 (0.5%) polyps. Of the 21 polyps that harbored premalignant lesions, 12 were interpreted as benign in diagnostic and surgical hysteroscopy. Of the polyps with cancer, 4 were also histeroscopically interpreted as normal. Conclusion : Symptomatic polyps in menacme and in all postmenopausal women should be resected and submitted to histopathological examination, since they may have a benign aspect, even when harboring areas of cellular atypia or cancer.

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

scholarly journals Histopathological study of endometrium in abnormal uterine bleeding

2012 ◽  
Vol 2 (4) ◽  
pp. 297-300 ◽  
Author(s):  
S Bhatta ◽  
AK Sinha
Keyword(s):  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Histopathological Study ◽  
Endometrial Sampling ◽  
Proliferative Endometrium ◽  
Malignant Lesions ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain

Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features.Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied.Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%).Conclusion: Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.Journal of Pathology of Nepal (2012) Vol. 2, 297-300DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882

Use of ultrasound imaging for the diagnosis of abnormal uterine bleeding in the bonnet macaque (Macaca radiata)

2016 ◽  
Vol 51 (1) ◽  
pp. 65-74
Author(s):  
Uddhav K Chaudhari ◽  
M Imran ◽  
Dhananjay D Manjramkar ◽  
Siddhanath M Metkari ◽  
Nilesh P Sable ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
3D Ultrasound ◽  
Uterine Bleeding ◽  
Colour Doppler ◽  
Endometrial Polyps ◽  
Non Invasive ◽  
Uterine Anomalies

Ultrasound is a powerful, low-cost, non-invasive medical tool used by laboratory animal veterinarians for diagnostic imaging. Sonohysterography and transvaginal ultrasound are frequently used to assess uterine anomalies in women presenting with abnormal uterine bleeding (AUB). In the present study, we have evaluated the abdominal ultrasound of bonnet monkeys ( n = 8) showing spontaneous ovulatory ( n = 5) and anovulatory ( n = 3) AUB. The ovulatory ( n = 5) macaques showed cyclic AUB for 7–8 days. The anovulatory ( n = 3) macaques had irregular AUB with menstrual cycles of 40–45 days. The B-mode abdominal, colour Doppler and 3D ultrasound scans were performed during the proliferative phase of the menstrual cycle. Ultrasound examination revealed endometrial polyps in five macaques and endometrial hyperplasia in three animals. The width and length of endometrial polyps was around 0.5–1 cm (average 0.51 ± 0.23 cm × 0.96 ± 0.16 cm) with significant increase in endometrial thickness ( P < 0.0002). 3D ultrasound also showed a homogeneous mass in the uterine cavity and colour Doppler ultrasound showed increased vascularity in the endometrial polyps. Endometrial hyperplasia characteristically appeared as a thickened echogenic endometrium ( P < 0.0002). This study demonstrates the use of non-invasive ultrasound techniques in the diagnosis of AUB in macaques.

scholarly journals Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

2017 ◽  
Vol 6 (9) ◽  
pp. 4081
Author(s):  
Jiten Sharma ◽  
Bhishan Dhiman ◽  
Nishi Sud ◽  
Anupriya Kaushik
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Uterine Bleeding ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling ◽  
Combined Use ◽  
Vaginal Ultrasonography

Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.

scholarly journals Clinicopathological analysis of AUB in perimenopausal and postmenopausal women in cancer care centre: special reference to carcinoma endometrium

2021 ◽  
Vol 10 (7) ◽  
pp. 2739
Author(s):  
Varsha Deshmukh ◽  
Afsha Suboohi ◽  
Archana Rathod ◽  
Jyoti Kodgire
Keyword(s):  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Total Sample ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Postmenopausal Bleeding ◽  
Medical College ◽  
Carcinoma Endometrium

Background: Abnormal uterine bleeding (AUB) may be defined as any variation from normal menstrual cycle including alteration in its regularity, frequency, duration of flow and amount of blood loss. Postmenopausal bleeding is a danger sign for malignancy. The study aimed to study the histopathology spectrum of hysterectomy specimens and bleeding patterns in perimenopausal women and postmenopausal women.Methods: It was a retrospective observational study done at Government Medical College and Cancer Hospital, Aurangabad (MS) from January 2017 to January 2021. Total sample size was 100 women. Perimenopausal and postmenopausal women undergoing hysterectomy were analysed for the age, parity, etieology, histology and the malignant changes.Results: 22 cases of AUB were observed in the age group of less than 40 years. 56% cases presented with heavy menstrual bleeding 58% cases had prolonged menstrual bleeding. 36% cases had endometrial cause (harmonal disturbances), 12 % had endometrial polyp and 35 cases out of 100 had endometrial carcinoma. Both type 1 and type 2 cases of carcinoma endometrium are seen in this study.Conclusions: Excessive uterine bleeding is a common gynaecological problem in all age groups with significant patient morbidity. The spectrum of endometrial lesions seen in AUB and cancer cases shows that the histopathological examination of endometrium is gold standard diagnostic tool in evaluation of AUB and postmenopausal bleeding and there is an age specific association of endometrial lesions.

scholarly journals Ultrasound in screening of endometrial carcinoma in asymptomatic postmenopausal women

2009 ◽  
Vol 62 (5-6) ◽  
pp. 263-267 ◽  
Author(s):  
Aleksandar Curcic ◽  
Srdjan Djurdjevic ◽  
Ljiljana Mladenovic-Segedi ◽  
Zorica Grujic ◽  
Nemanja Visnjevac
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Ultrasound Examination ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Screening Method ◽  
Uterine Bleeding ◽  
Ultrasound Finding ◽  
Gynecological Examination ◽  
Significant Difference

Introduction The aim of this prospective study was to investigate whether there was a significant difference in ultrasound detection of pathologic states of endometrium between asymptomatic postmenopausal women and postmenopausal women with uterine bleeding in whom the thickness of endometrium was greater than 3 mm at ultrasound examination. Material and methods The study included 128 postmenopausal women with uterine bleeding and 29 asymptomatic posmenopausal women who underwent gynecological examination, transvaginal ultrasound examination, fractional explorative curettage and histopathological examination of the endometrium. Results The results showed no statistically significant difference between the examined groups of women in relation to the detection of pathologic states of the endometrium (polyps, hyperplasias and carcinomas) as well as between individual pathologic states, although the research showed that the asymptomatic women were more frequently presented with well-differentiated carcinoma versus the medium-differentiated carcinoma in the symptomatic group of women. Conclusion It can be concluded that the transvaginal ultrasound examination in postmenopausal women could be an adequate screening method for detection of endometrial carcinoma in early asymptomatic stage of the disease, whereas in the women with ultrasound finding of the thickened endometrium, the final diagnosis should be established by histopathological examination of the endometrium samples obtained by hysteroscopy, instead of previously used explorative curettage.

scholarly journals Sonographic and histopathological correlation and evaluation of causes of abnormal uterine bleeding in perimenopausal women

2019 ◽  
Vol 8 (10) ◽  
pp. 3920
Author(s):  
Garima Kumari ◽  
Kuldeep Poonia
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
First Line ◽  
Histopathological Correlation ◽  
Perimenopausal Women ◽  
Pathological Evaluation ◽  
A Prospective Study

Background: Perimenopausal period in a woman’s lifetime marks a transition from reproductive phase to that of menopause. Abnormal uterine bleeding (AUB) is a common problem among women in the reproductive age.Methods: It was a prospective study on 100 perimenopausal women in age group 39-51 years with abnormal uterine bleeding who underwent Hysterectomy at SMS Hospital, Jaipur. At the end clinical diagnosis, ultrasonographic findings and histopathological reports were correlated.Results: 42.0% cases had HMB menstrual pattern followed by 24.0% cases had HPMB and 18.0% of the cases had PB. Intermenstrual bleeding was seen in 2% cases.  In clinical finding, 71.0% cases had fibroid followed by 15.0% cases had adenomyosis and 6.0% of the cases had fibroid+adenomyosis. The clinical diagnosis was confirmed by ultrasonography. Ultrasound detected fibroid in 95.8% of the cases who were suspected to have fibroid on clinical examination. Out of the 15 patients who were clinically suspected to have adenomyosis, 53.3% confirmed on ultrasound, ultimate diagnosis was made on the basis of histology, so every hysterectomy specimen was sent for histopathological examination. Out of the 68 patients who were diagnosed to have fibroid uterus on ultrsonography, 66 patients were confirmed to have fibroid. Out of the 8 patients who were labelled as adenomyosis after ultrasound, 4 patients were diagnosed to have adenomyosis on histopathology and in rest 4 patients, no gross pathology was detected.Conclusions: A transvaginal ultrasound should be offered as the first line of imaging. Clinical, radiological and pathological evaluation correlated well to diagnose fibroids, however clinically as well as USG proved to be of little help in diagnosing adenomyosis.

Evaluation of Abnormal Uterine Bleeding as a Predictor of Pre-Malignant or Malignant Lesions Present in Endometrial Polyps

2008 ◽  
Vol 15 (6) ◽  
pp. 54S-55S ◽  
Author(s):  
M. Siedhoff ◽  
A.A. Arslan ◽  
B. Day ◽  
S. Marshall ◽  
K. Phillips ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Malignant Lesions

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

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