Spectrum of Histological Changes in Endometrial Biopsies with Abnormal Uterine BleedingSpectrum of Histological Changes in Endometrial Biopsies with Abnormal Uterine Bleeding

Abstract

Objective: To identify and characterize the diagnostic features of endometrial biopsies in cases
presenting with abnormal uterine bleeding and to determine the types and frequencies of endometrial
pathologies in these cases.
Materials and Methods: The study was conducted at Department of Pathology, Pakistan Institute of
Medical Sciences (PIMS), Islamabad. The duration of study was 6 months. The study included 100 cases
of endometrial biopsies. Relevant clinical history was taken from the patient and the results of other
investigations were also noted. The specimens were grossed and then processed. Cutting of sections
was done at 3 to 5 microns, and stained with H&E. Slides were evaluated for positive histopathological
findings.
Results: Most of the patients were in the age of 20 to 50 years with mean age of 37 years.
The various conditions responsible for abnormal uterine bleeding in this study were 34 cases of
estrogen dominance, 10 cases of abnormal secretory phase, 6 cases of anovulatory endometrium, 6
cases of pill-effect endometrium, 3 cases of simple cystic hyperplasia, 3 cases of chronic endometritis, 2
cases of luteal phase defect and 1 case of atrophic endometrium. All these patients were in the age
group 20 to 60 years and most of the samples were in the age group 30 to 45 years. Polymenorrhagea
was the most common complaint. The results of this study are compared with national and
international studies.
Conclusion: Hormonal imbalance is a very broad term and may lead to misinterpretation. It will be a
challenge for the pathologists to do serum hormone levels for each and every patient and to correlate it
with histopathological findings.
Complete clinical history is very important in this regard especially LMP and hormonal therapy has a
crucial role in the diagnosis of endometrial biopsies.