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.

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals Alveolar Rhabdomyosarcomatous endometrial polyp in a 70-year-old woman

2018 ◽  
Vol 7 (8) ◽  
pp. 3422
Author(s):  
Niranjanakesav . ◽  
Sathiya Bama ◽  
Radhakrishnan . ◽  
Arbind Kumar
Keyword(s):  
Case Report ◽  
Short Duration ◽  
Vaginal Bleeding ◽  
Vaginal Discharge ◽  
Endometrial Polyp ◽  
Alveolar Rhabdomyosarcoma ◽  
Speculum Examination ◽  
Abnormal Vaginal Bleeding

TThis case report concerns a 70-year woman with a complaint of abnormal vaginal bleeding and foul smelling vaginal discharge of a short duration. Speculum examination revealed a huge polyp occupying the cervix and extending further downwards. On operation, it turned out to be an endometrial polyp arising from the fundus. Histologically the polyp showed classical features of alveolar rhabdomyosarcoma; confirmed immunochemically.

scholarly journals Determine the Frequency of Endometrial Hyperplasia in Female with Abnormal Vaginal Bleeding

2021 ◽  
Vol 15 (7) ◽  
pp. 1779-1781
Author(s):  
Ayesha Naeem ◽  
Amna Aslam ◽  
Amber-u- Nissa ◽  
Tayyaba Rasheed ◽  
Tanweer Akhtar ◽  
...  
Keyword(s):  
Vaginal Bleeding ◽  
Endometrial Hyperplasia ◽  
Economic Status ◽  
Transvaginal Ultrasound ◽  
Adenomatous Hyperplasia ◽  
Cross Sectional ◽  
Socio Economic Status ◽  
Ultrasound Frequency ◽  
Abnormal Bleeding ◽  
Abnormal Vaginal Bleeding

Objective: To determine the frequency of endometrial hyperplasia in female with abnormal vaginal bleeding. Study Design: Cross-sectional Place and Duration of Study: Department of Obstetrics & Gynaecology, Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st January 2021 to 31st March 2021. Methodology: One hundred and ten females with abnormal bleeding were presented in this study. Patients were aged between 40-65 years. Demographically details of age, weight, body mass index and socio economic status were recorded after taking written consent. Complete patients were undergone for transvaginal ultrasound. Frequency of endometrial hyperplasia was recorded. Results: Mean age of the females was 47.16±7.53 years with mean BMI 26.17±8.44 kg/m2. Mean weight of the patients were 59.16±17.66 kg. Most of the patients 65 (59.09%) were from urban area and majority of the patients 70 (63.64%) were illiterate. Sixty (54.5%) cases were from low socio-economic status and 50 (45.5%) had high socio-economic status. Endometrial hyperplasia was found in 25 (22.73%) patients, in which 18 (72%) had cystic hyperplasia, adenomatous hyperplasia found in 4 (16%) and 3 (12%) had atypical hyperplasia. Among 25 cases of hyperplasia, menorrhagia found in 15 (60%), polymenorrhea found in 8 (32%) and polymenorrhagia in 2 (8%). Medical treatment were given to 20 (80%) cases and surgical treatment were given to 5 (20%). Conclusion: The prevalence of endometrial hyperplasia was 22.73% among women with abnormal bleeding. It can be cure by early diagnosis and treatment. Keywords: Transvaginal ultrasound (TVS), Endometrial hyperplasia, Abnormal vaginal bleeding, Menorrhagia

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 Hyperplastic processes in the endometrium of postmenopausal women

2021 ◽  
pp. 48-54
Author(s):  
Yu. A. Lyzikova ◽  
A. N. Lyzikov
Keyword(s):  
Postmenopausal Women ◽  
Endometrial Hyperplasia ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Area Under The Curve ◽  
Endometrial Biopsy ◽  
Retrospective Case ◽  
Normal Endometrium ◽  
Ultrasound Study ◽  
Endometrial Pathology

Objective: to specify indications for endometrial biopsy in postmenopausal women with endometrial pathology revealed by ultrasound, to study the structure of comorbidity, the parity of pregnancies and childbirth in patients with endometrial hyperplasia.Material and methods. We performed an observational retrospective case-control study. The study included 60 postmenopausal patients with endometrial pathology revealed by ultrasound referred for further endometrial biopsy. After the results of the histological examination of the endometrium had been obtained, 30 patients who had detected endometrial pathology were included in the study group, 30 patients with histologically normal endometrium were included in the comparison group.Results. In comparing clinical and anamnestic data, no statistically significant differences have been found between the groups. The comparison of the indices of the ultrasound study of the uterus has revealed a statistically significant M-echo value in patients with confirmed endometrial pathology — 10.00 (8.00; 13.00) mm, in the comparison group — 7.80 (6.00; 9.75) mm. If an M-echo value is > 7 mm with a sensitivity of 76.67 % and a specificity of 46.65%, endometrial pathology is likely to develop. The area under the curve (AUC) was 0.706 (95 % CI 0.574 — 0.816; p < 0.001).Conclusion. The obtained data determine an M-echo value more than 7 mm detected by ultrasound as an indication for endometrial biopsy in postmenopausal patients. If an M-echo value is from 5 to 7 mm and clinical manifestations are absent, dynamic observation with ultrasound control can be performed. No specific risk factors for the disease have been found in the postmenopausal patients with endometrial hyperplasia, which necessitates the search for the genetic markers of estrogen metabolic disorders.

scholarly journals ENDOMETRIAL STUDY OF ABNORMAL UTERINE BLEEDING IN WOMEN AT 45 YEARS AND ABOVE

2003 ◽  
Vol 42 (146) ◽  
pp. 83-85
Author(s):  
Ganesh Dangal
Keyword(s):  
Vaginal Bleeding ◽  
Elderly Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Abnormal Bleeding ◽  
Post Menopausal ◽  
Abnormal Vaginal Bleeding

ABSTRACTThe study is done to know the causes for the abnormal uterine bleeding in perimenopausal women atChitwan valley and to compare the histopathological findings between the pre-menopausal andpostmenopausal women. Retrospective analysis of patients who have had abnormal bleeding during a periodof one and a half years' from January 2000 to June 2001 in Department of Gynaecological Oncology of BPKoirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. There were total sixty women (aged 45years and above) having abnormal bleeding managed at BPKMCH. A total of sixty patients were studied.Majority (57%) of them was postmenopausal ladies presented with abnormal vaginal bleeding. The agerange was 45 to 81 years. Only 37% had pathological bleeding including malignancies and only about 17%had malignancies. Malignant diseases were found in 7.7% cases in the pre-menopausal ladies whereas itwas 23.4%, almost three times higher, in the post-menopausal ladies. Carcinoma of the cervix and of theendometrium occurred with increasing frequency with increasing age in this study. So, a thorough work-upis needed for the elderly women presenting with an abnormal vaginal bleeding especially to rule outmalignancies.Key Words: endometrial biopsy, endometrial cancer, postmenopausal bleeding.

scholarly journals Incidental Finding of Persistent Hydatidiform Mole in an Adolescent on Depo-Provera

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Olukayode Akinlaja ◽  
Rebecca McKendrick ◽  
Zineb Mashak ◽  
May Nokkaew
Keyword(s):  
Vaginal Bleeding ◽  
Incidental Finding ◽  
Hydatidiform Mole ◽  
Signs And Symptoms ◽  
Gestational Trophoblastic Disease ◽  
Positive Pregnancy Test ◽  
Life Threatening ◽  
Depo Provera ◽  
Abnormal Vaginal Bleeding ◽  
High Index Of Suspicion

Molar pregnancies represent an uncommon yet important obstetric problem with potentially fatal outcomes. Patients typically present with signs and symptoms of early pregnancy, and physicians most often suspect nonmolar pregnancy complications initially; however a hydatidiform mole should be included in the differential diagnosis of a woman with a positive pregnancy test and abnormal vaginal bleeding irrespective of the use of contraception. Our case is that of an adolescent female on Depo-Provera injectable contraceptive with increased vaginal bleeding, abdominal pain, nausea, and vomiting who was incidentally found to be pregnant and subsequently diagnosed with a molar pregnancy despite persistent denial of having initiated sexual intercourse. Though gestational trophoblastic disease is uncommon with an incidence of about 1-2 cases per 1,000 pregnancies, a clinician has to display a high index of suspicion when dealing with patients at extremes of age in order to avoid potentially life-threatening outcomes.

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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