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The Diagnostic Value of Endometrial Biopsy in Postmenopausal Uterine Bleeding

Divya K.N.* , Divya K.N.* , Jayashree K.** , Bharath C.***

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Indian Journal of Pathology: Research and Practice 6(1):p 45-51, January - March 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6117.7

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Abstract

 Post­menopausal uterine bleeding is the cause of discomfort and inconvenience, affecting millions of women. Endometrial sampling is the effective means of evaluating the women with post­ menopausal uterine bleeding. Objectives: To study the histopathological pattern of the endometrial biopsies of patients with post­menopausal uterine bleeding and to correlate the abnormal endometrial pattern with different clinical presentations and age groups. Methods: The present study included evaluation of 60 cases of post­menopausal uterine bleeding diagnosed in the Department of Pathology, Vijayanagar Institute of Medical Sciences, Ballary, over a period of 1 year, from June 2015 to June 2016. The specimens were processed, embedded and cut into sections of 3­5 microns. The histopathological patterns of the endometrial biopsies were studied. Results: Atrophic endometrium formed the bulk of post­menopausal bleeding (50.0%). Non­neoplastic and benign neoplastic lesions including endometritis, polyp and hormone induced lesions formed 25.0%. 11 cases of endometrial hyperplasias (18.3%) and 4 cases of adenocarcinoma (6.7%) were encountered. The incidence of postmenopausal bleeding decreased with increasing age while the probability of cancer as the underlying cause increased. The peak incidence of endometrial carcinoma was found in women between 65 and 69 years of age. Conclusion: Endometrial biopsy is a valuable means for differentiating various benign lesions of uterine cavity, including atrophic endometrium, endometritis, endometrial polyp, and hormone­induced changes. Microscopic assessment of postmenopausal bleeding has great value in the identification of endometrial hyperplasia and carcinomas. Endometrial biopsy should be a part of diagnostic work up of the patients with postmenopausal bleeding to ensure accurate diagnosis and correct management.

Keywords: Post­Menopausal Bleeding; Endometrial Biopsy; Histopathology; Patterns.

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6117.7

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