scholarly journals Concordance between the Hysteroscopic Diagnosis of Endometrial Hyperplasia and Histopathological Examination

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 142 ◽  
Author(s):  
De Franciscis ◽  
Riemma ◽  
Schiattarella ◽  
Cobellis ◽  
Guadagno ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
University Hospital ◽  
Clinical Indication ◽  
Histopathological Diagnosis ◽  
Office Hysteroscopy ◽  
Predictive Values ◽  
Endometrial Thickening ◽  
Post Menopause

The goal of this paper is to assess the concordance between the clinical diagnosis of Endometrial Hyperplasia (EH), suspected by senior gynecologists throughout outpatient office hysteroscopy, and the results from histopathological examination, in order to evaluate hysteroscopic accuracy for EH. A prospective cohort study was done at a Tertiary University Hospital. From January to December 2018, we enrolled women with the following criteria: abnormal uterine bleeding in post-menopause and endometrial thickening in pre-or post-menopause. Patients underwent office hysteroscopy with a 5 mm continuous-flow hysteroscope, and endometrial biopsies were taken using miniaturized instruments. Senior operators had to foresee histopathological diagnosis using a questionnaire. Histopathological examination was conducted to confirm the diagnosis. This study was approved by the local ethical and registered in the ClinicalTrials.gov registry (ID no. NCT03917147). In 424 cases, 283 clinical diagnoses of EH were determined by senior surgeons. A histopathological diagnosis was then confirmed in 165 cases (58.3%; p = 0.0001). Furthermore, 14 endometrial carcinoma and atypical hyperplasia were found. The sensitivity, positive predictive value, and negative predictive values for EH were, respectively, 90.4, 58.4, and 86.6%. Subdivided by clinical indication, the sensitivity was higher in patients with post-menopause endometrial thickening. The diagnostic accuracy of office hysteroscopy in the diagnosis and prediction of endometrial hyperplasia was high. Senior operators could foresee EHs in more than half the cases.

scholarly journals DIAGNOSTIC HYSTEROSCOPY IN ABNORMAL UTERINE BLEEDING & IT'S HISTOPATHOLOGIC CORRELATION: OUR EXPERIENCE

2013 ◽  
Vol 03 (02) ◽  
pp. 013-017
Author(s):  
Neetha Nandan ◽  
Lakshmi Manjeera ◽  
Supriya Rai ◽  
Mangala Gowri
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histopathological Diagnosis ◽  
Normal Endometrium ◽  
The Past ◽  
Dilatation And Curettage ◽  
Medical Academy ◽  
Diagnostic Hysteroscopy

Abstract Aims & objectives: 1) To study the accuracy of hysteroscopy in evaluation of abnormal uterine bleeding in perimenopausal and postmenopausal women. 2) To correlate hysteroscopic findings with histopathologic results. Materials and methods: It is a retrospective study done in the department of OBG at K. S.Hegde Medical Academy, Mangalore. All patients who underwent diagnostic hysteroscopy for abnormal uterine bleeding in the past 6 years were included in this study. Patients underwent clinical and sonographical evaluation. Following hysteroscopic evaluation, patients had undergone dilatation and curettage and endometrial curetting were sent for histopathological examination (HPE). The correlation between findings on hysteroscopy & HPE were tabulated. Results: On hysteroscopy, endometrium was classified as suggestive of normal, hyperplasia, atrophic, polyp, fibroid, cancer. Histopathological diagnosis was taken as gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. Out of 175 patients, 108 patients were diagnosed to have endometrial hyperplasia on hysteroscopy, however only 53 confirmed to have on histopathologically. Similarly 25 patients were said to have normal findings on hysteroscopy but by histopathology 85 were having normal endometrium. Hysteroscopy was highly specific for diagnosis of polyp (95.9%), cancer (100.0%), and atrophy (96. 9%), normal endometrium (92.2%) but low specificity for diagnosing hyperplasia (48.4%). The sensitivity of hysteroscopy in diagnosing polyp and endometrial hyperplasia were 100% and 84.9% respectively but it was low in case of cancer (16.7%) and normal endometrium (21.2%). Conclusion: Hysteroscopy is a highly accurate diagnostic tool in diagnosing intrauterine lesions like endometrial polyp and submucous fibroid. In fact, it was also found to be highly specific in conditions like endometrial cancer, polyp, atrophic and normal endometrium.

scholarly journals Clinicopathological correlation of abdominal hysterectomy

2020 ◽  
Vol 9 (11) ◽  
pp. 4361
Author(s):  
Tara Manandhar ◽  
Sarita Sitaula ◽  
Baburam Thapa Dixit ◽  
Ajay Agrawal
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Clinical Indication ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Common Indication ◽  
Fibroid Uterus

Background: Hysterectomy is the most common gynaecological procedure performed worldwide. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. Fibroid uterus is the most common indication for hysterectomy followed by pelvic organ prolapse, benign ovarian tumour and abnormal uterine bleeding. The objective of this study was to analyse the indication, outcome and correlate the clinical indication with the histopathological diagnosis.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, B. P. Koirala Institute of Health Sciences, from January 2017 to December 2019. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.Results: A total of 801 patients underwent abdominal hysterectomy and the most common indication was fibroid uterus (n=391, 48.81%), followed by abnormal uterine bleeding. The total complication rate was 3.24% (n=26) and we had one (0.1%) mortality. Histopathological analysis of the specimen revealed leiomyoma (54.43%) as the most common finding. The clinical indication and histopathological diagnosis matched in 373 (86.94%) patients.Conclusions: Abdominal hysterectomy is the most common approach and it is associated with risk of complications, so the indication for hysterectomy should be adequately evaluated. With the improvement in the different organ-preserving options, hysterectomy in benign disease should only be opted when all the other conservative options fails.

scholarly journals Role of Sonography in the Evaluation of Endometrial Aetiology in Abnormal Uterine Bleeding

2021 ◽  
Vol 8 (12) ◽  
pp. 682-687
Author(s):  
Seema Pandey ◽  
Mamta Kumari ◽  
Amrita Chaurasia ◽  
Gyan Prakash
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Saline Infusion ◽  
Transvaginal Sonography ◽  
Care Hospital ◽  
Female Population ◽  
Saline Infusion Sonography ◽  
Vaginal Sonography

BACKGROUND Abnormal uterine bleeding is an important cause of morbidity in the female population, which can be attributed to several reasons. Trans-vaginal sonography and saline-infusion sonography are the mainstay of diagnosis and govern the further management of this condition. This study was conducted to evaluate the thickness and pattern of endometrium with transvaginal sonography and determine any abnormality in the uterine cavity which can be attributed to saline infusion sonography (SIS) in cases of abnormal uterine bleeding (AUB). METHODS The study was conducted among 122 women with complaints of abnormal uterine bleeding attending Outpatient Department and indoor cases of a tertiary care hospital over a period of twelve months. RESULTS The most common presenting complaint was heavy menstrual bleeding in 27.04 % cases. Maximum (44.26 %) cases had normal finding on transvaginal sonography; most common pathological finding was leiomyoma (22.31 %), and endometrial hyperplasia (15.5 %). More than one third (37.7 %) of patients had no abnormalities on saline infusion sonography; while 62.3 % had one or more pathologies; the most common lesion was fibroid in 25.4 % cases. Normal proliferative and secretary endometrium was found on histopathological examination in 50 % cases, while remaining half cases had one or more pathology, most common pathology detected was endometrial hyperplasia in 25.4 % cases. On trans-vaginal sonography (TVS), 11 cases of endometrial polyp were missed, which were detected after infusion of saline and confirmed by histopathological examination. The diagnostic indices of SIS were superior to TVS in diagnosis of any pathology. Sensitivity of TVS was 86.94 % and SIS was 91.94 %. Specificity of TVS (75.41 %) was greater than SIS (68.33 %). CONCLUSIONS TVS and SIS scanning techniques play a very important role in endometrial disorders in woman with AUB. KEYWORDS SIS, Transvaginal, AUB, Endometrium

scholarly journals Adenomyosis: correlating clinical suspicion with histopathological diagnosis in a retrospective study

2019 ◽  
Vol 8 (12) ◽  
pp. 4674
Author(s):  
Preet Kamal ◽  
Ripan Bala ◽  
Madhu Nagpal ◽  
Harleen Kaur
Keyword(s):  
Retrospective Study ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Organs ◽  
Histopathological Diagnosis ◽  
Medical Sciences ◽  
Common Causes ◽  
Chief Complaints ◽  
The Common ◽  
Chronic Cervicitis

Background: Adenomyosis and leiomyoma are the common causes of abnormal uterine bleeding (AUB). In this study it is aimed to evaluate the correlation of clinical and histopathological examination (HPE) of these entities leading to abnormal uterine bleeding.Methods: This retrospective study was carried out on hysterectomy specimens of subjects who presented themselves in the department of obstetrics and gynaecology of Sri Guru Ram Das Institute of medical sciences and research, Amritsar with chief complaints of AUB not responding to conservative treatment.Results: A total of 100 women with clinical diagnosis of AUB in which hysterectomies were performed, leiomyoma was found in 42% cases, adenomyosis in 22% cases. The most frequent combination of diagnosis was leiomyoma and adenomyosis i.e. 26%. In 9% cases chronic cervicitis and ovarian cyst were detected. In one case endometrial malignancy was found.Conclusions: Though adenomyosis and leiomyoma are clinically diagnosed along with other pathological conditions of the reproductive organs but their confirmation is still to be relied upon HPE; a most important investigation.

Premalignant and Malignant Changes in Symptomatic Endometrial Polyps in Women Aged 20-70 years

2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Susan Abed Zaidan ◽  
Alaa Abdulqader Abdulrazaq ◽  
Eaman Marouf Muhammed
Keyword(s):  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Common Finding ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Age Group ◽  
Endometrial Polyps ◽  
Malignant Changes ◽  
Post Menopausal ◽  
Malignant Polyps

Background: endometrial polyps are localized over growth of endometrium including glandular and stromal tissue with prominent angiogenesis regulated by growth factors. Polyps occur in different age group and could be asymptomatic and discovered incidentally or it cause abnormal premenopausal and postmenopausal bleeding. Most endometrial polyps are benign but premalignant and malignant changes also occur frequently. Objective: this study was carried out to identify the age-group in which endomaterial polyps are encountered in routine surgical pathology practice, to document the agegroup in which these polyps underwent malignant changes and to identify the histological subtype of endometrial polyps according to age group. Patients and methods: This prospective study conducted to demonstrate the premalignant and malignant changes in symptomatic endometrial polyps in relation to patients age group ranging from 20-70 years with abnormal uterine bleeding examined in gynecology and obstetric department in Al-Ramadi and Al-Yarmouk Teaching Hospital during the period from January 2017 to May 2018. The endometrial samples were obtained either by D and C, hysteroscopy or the polyps were demonstrated after surgical hysterectomy. All endometrial samples were fixed in 10% formalin solution and sent to the private histopathology laboratory in Baghdad for histopathological diagnosis. Results: The total number of examined women were 150. The most common recorded age was 20-70 years. 74.6% were premenopausal and 25.4% of patients were post-menopausal at the time of diagnosis. Most of patients presented with symptomatic polyps in this study were in age group 41-50 years (36.6%) in which most of the polyps were benign, while premalignant and malignant changes were more common in women between 51-60 years. The final pathological diagnoses showed benign endometrial polyps (49.3%), (48.6%) were pre-malignant polyps and (2 %) were malignant polyps. From benign lesions secretary endometrium was the most common finding in 43 cases (58.1%), while simple endometrial hyperplasia without atypia was the most common finding in the pre-malignant group 40 cases (54.7%). The distribution of histopathological changes in each age group were significant with a P value equal to 0.02. Conclusion: all endometrial polyps in pre- and post-menopausal women should be removed and submitted for histopathological examination as some of them even though there are benign but could carry areas of cellular atypia or malignant transformation.

scholarly journals Accuracy of Preoperative Endometrial Sampling for the Detection of Endometrial Pathology: a Retrospective Study

2017 ◽  
pp. 23
Author(s):  
Keven P M Tali ◽  
Lilli M T Cole
Keyword(s):  
Endometrial Hyperplasia ◽  
Frozen Section ◽  
Medical Center ◽  
Abnormal Uterine Bleeding ◽  
Study Data ◽  
Endometrial Biopsy ◽  
Predictive Values ◽  
Endometrial Sampling ◽  
Test Result ◽  
Endometrial Pathology

Objective: To investigate the accuracy of endometrial sampling in the diagnosis of endometrial pathology and the need of intraoperative frozen section. Methods: One hundred forty women who underwent endometrial sampling followed by hysterectomy between 2011 and 2014 were included in this study. Data were retrieved from patient files and pathology archives in Department of Obstetrics and Gynecology, Jose R. Reyes Memorial Medical Center, Manila, Philippines. Results: There were 25 patients with malignancy but endometrial sampling detected only 22 of them. The endometrial sampling sensitivity and specificity for detecting cancer were 88% and 100%, respectively with negative and positive predictive values of 97.5% and 100%, respectively. In 3 patients, the endometrial sampling failed to detect malignancy; 1 patient had a preoperative diagnosis of complex hyperplasia with atypia, 1 patient had complex hyperplasia without atypia and 1 patient had adenofibroma. A total of eighty patients had benign findings. There were fifty-three cases with finding of proliferative endometrium and twenty-seven were secretory. Twenty-three (55.0%) and 11 (39.0%) cases were confirmed by the hysterectomy specimen, respectively. The sensitivity of endometrial sampling in detecting benign samples was 76.0% and the specificity reached up to 83.0%. The histopathology result of the other fourteen cases were reported of having atrophy, twelve cases were reported of having endometrial hyperplasia, four with basal endometrium, four with endometrial polyp and one with adenomyosis. Conclusion: Outpatient endometrial biopsy has a high overall accuracy in diagnosing endometrial cancer when the specimen obtained is sufficient. A positive test result is more accurate for ruling in disease than a negative test result is for ruling it out. However, the diagnosis should be confirmed by frozen section in patients with complex hyperplasia and adenofibroma. [Indones J Obstet Gynecol 2017; 5-1: 23-29] Keywords: abnormal uterine bleeding, endometrial hyperplasia, endometrial sampling, frozen section, pipelle

A STUDY OF CLINICAL CORRELATION WITH HISTOPATHOLOGICAL DIAGNOSIS OF ABNORMAL UTERINE BLEEDING AT JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 73-74
Author(s):  
Archana Jha ◽  
Satyendra Kumar ◽  
[Prof.] Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Clinical Impression ◽  
Histopathological Diagnosis ◽  
Endometrial Sampling ◽  
Carcinoma Of Cervix ◽  
Perimenopausal Women ◽  
Pathological Evaluation

Background: Abnormal uterine bleeding in perimenopausal women accounts for about 70% of gynaecologic Outpatient Department visits. Perimenoppause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more or less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Polymenorrhagia, intermenstrrual bleeding and metrorrhagia are other common disorders at perimenopause. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding after ruling out medical causes. The present study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with clinical diagnosis and histopathological examinations. A total of 150 perimenopausal Material and Methods: women with abnormal uterine bleeding in the age group of 37-51 years for a period of 6 months were included. These women were evaluated clinically and ultrasonographically for the cause of abnormal uterine bleeding. Clinical impression and USG reports were correlated. These women underwent dilatation and curettage for endometrial sampling and specimen sent for histopathological examination. Histopathological reports were correlated with clinical diagnosis. Most of the patients with AUB were Results: between 37-41 years of age (56%). The incidence was high in parity-3 (26%) annd grand multipara (49.33%). The majority of the women were presented with menorrhagia (54.66%). Clinically, majority of the cases were diagnosed as broids 66 (44%) followed by dysfunctional uterine bleeding (DUB) 56 (37.33%). However, histopathological reports conrmed broid in 52 cases, DUB in 49, adenomyosis in 36 and polyp in 11 cases. Fibroi Discussion: ds are common nding in women with menorrhagia. Clinical, radiological and pathological evaluation correlated very well to diagnose broids and DUB. However clinically as well USG proved of little help to diagnose adenomyosis and carcinoma of cervix and endometrium. Thus, histopathological evaluation of endometrium is recommended in perimenopausal women.

scholarly journals Histopathological spectrum of endometrium in abnormal uterine bleeding

2018 ◽  
Vol 7 (9) ◽  
pp. 3633 ◽  
Author(s):  
Simridhi Bindroo ◽  
Monika Garg ◽  
Tajinder Kaur
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Age Groups ◽  
Healthy Woman ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Proliferative Endometrium ◽  
Histopathological Workup ◽  
Endometrial Carcinomas

Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding.

scholarly journals Office Hysteroscopy as a Valid Tool for Diagnosis of Genital Tract Lesions in Females with Intact Hymen

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Hui-Yu Huang ◽  
Yi-Ting Huang ◽  
Kai-Yun Wu ◽  
Yu-Ying Su ◽  
Cindy Hsuan Weng ◽  
...  
Keyword(s):  
Genital Tract ◽  
Endometrial Hyperplasia ◽  
Outpatient Setting ◽  
Chang Gung Memorial Hospital ◽  
Postmenopausal Bleeding ◽  
Office Hysteroscopy ◽  
Endometrial Thickening ◽  
History Of ◽  
Diagnostic Hysteroscopy ◽  
Endometrial Pathology

Background. To evaluate the feasibility and applicability of using office hysteroscopy in women with intact hymen. Methods. We recruited 836 patients with intact hymen with different indications who underwent diagnostic hysteroscopy without anesthesia in an outpatient setting from 2007 to 2016 at Chang Gung Memorial Hospital at Linkou. Results. Patients’ mean age was 35 ± 10.6 years (range 3–69 years). Most patients (86.4%) with postmenopausal bleeding had intrauterine lesions, and they were especially at high risk (50%) for endometrial hyperplasia or malignancy. Five hundred thirty (63.3%) patients had histologic findings confirming concordance between hysteroscopic and histologic findings. Submucosal myoma had the highest concordance (96.3%), whereas endometrial hyperplasia had the lowest concordance (50%). Forty-eight patients (5.7%) had endometrial hyperplasia, and 35 patients (4.2%) had endometrial malignancy. Two patients who were thought to have nonspecific endometrial thickening actually had endometrial pathology. Conclusions. Hysteroscopy through vaginoscopic approach is feasible and well-tolerated in the patients with intact hymen. This outpatient procedure provides accurate evaluation of lesions of the genital tract and should be considered in patients without a history of intercourse.

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