Spectrum of Histological Changes in Endometrial Biopsies with Abnormal Uterine Bleeding

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Spectrum of Histological Changes in Endometrial Biopsies with Abnormal Uterine Bleeding

Pordil Khan*, Farhan Abbas Baloch** and Ahmareen Khalid***
* Department of Pathology, Bacha Khan Medical College, Mardan, ** Department of Pathology, Pak International Medical
College, Peshawar, *** Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.

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.
Keywords: Endometrium, estrogen dominance, abnormal secretory phase endometrium.


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