The histopathology of endometrial biopsies done for abnormal uterine bleeding

[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 femalespresenting with AUB and determine the percentage having organic causes for AUB in each of theseage groups.Method: All pipelle aspiration/curettage specimens received during the year 2020 were included.Evacuated products of conception were excluded. The patient characteristics, clinical informationandhistopathological findings were obtained. All cases were stratified into age groups 20-39 (A), 4050(B) and >50 years (C). The histological findings were classified as normal pattern (NP), ovulatorydysfunction (OD), exogenous hormonal effects (EHE), endometrial polyp (EP), chronic endometritis(CE), atrophic endometrium (AE), disordered proliferative endometrium (DPE), endometrialhyperplasia (EH) and endometrial carcinoma (EC). EP, CE, EH and EC were considered structuralcauses.Results: A total of 355 specimens were analysed. The age range of patients was 24-74 years (A-49, B191, C-115). In the 20-39 age group 13/49 (26.53%) accounted for organic causes (EP-22.4%, CE- 2%,EH-2%). In the 40-50 age group 25/191(13%) were due to organic causes (EP-7.32%, CE-1.57%, EH3.66%, EC- 0.52%). In the >50 age group 29/115 (25.2 %) were due to organic causes (EP- 13.04%, EC10.43%, EH-1.73%). The commonest histological finding for AUB in the > 50 age group was AE-23/115(23%), in the 20-39 age group EHE-13/49 (26.5%) and in the 40-50 year age group NP-55/191(28.79%).Conclusion: There is a variation in the histomorphological findings for AUB among different agegroups, and non-structural findings are commoner than organic ones.

[学科分类] 生理学与病理学