The histopathology of endometrial biopsies performed for abnormal uterine bleeding: an audit in a tertiary care centre in Sri Lanka

[摘要] Introduction: The main indication for endometrial curettage and pipelle aspiration is abnormal uterinebleeding (AUB). Histological assessment is important in determining the various structural and nonstructural aetiologies for AUB.Objectives: To describe the histomorphology of the endometrium in different age groups of patientspresenting with AUB and to determine the percentage having organic causes for AUB in each of theseage groups.Methodology: All the uterine curettage and pipelle aspiration specimens received during a period twoyears from January 2019 to December 2020 were included in the study. Evacuated products ofconception were excluded. The patient characteristics, clinical information and the histopathologicalfindings were obtained. All cases were stratified into age groups 20-39 (reproductive), 40-50(perimenopausal) and >50 years (postmenopausal). The histological findings were classified as normalpattern (NP), ovulatory dysfunction (OD), exogenous hormonal effects (EHE), endometrial polyp (EP),chronic endometritis (CE), atrophic endometrium (AE), disordered proliferative endometrium (DPE),endometrial hyperplasia (EH) and carcinoma (CA). EP, CE, EH and CA were considered structural/organic causes.Results: A total of 778 specimens were analysed. The age range of the patients was 25–80 years(reproductive - 98, perimenopausal - 440, postmenopausal - 240). Structural / organic causes werefound in 20.41% (20/98) in the 20–39-year age group (EP-15.31%, CE-4.08%, EH-1.02%), 12.95%(57/440) in the 40–50-year age group (EP-6.36%, CE-2.04%, EH-4.09%, CA-0.45%) and 29.58% (71/240)in the >50 age group (EP-14.17%, CA-10.83%, EH-4.58%). The commonest histological finding for AUBin the >50 age group was AE (22.08%,53/240). NP was the commonest in both the perimenopausal(29.55%, 130/440) and reproductive groups (30.61%,30/98).Conclusion: There is a variation in the histomorphological findings for AUB among different agegroups, and non-structural findings are commoner than structural / organic causes.

[学科分类] 生理学与病理学

[关键词] abnormal uterine bleeding (AUB);organic causes;curettage;pipelle aspiration