Abstract
BACKGROUND: The gold standard diagnostic method for abnormal uterine bleeding is an endometrial histopathology examination. This condition is widespread in gynecological complaints. One of the most prevalent gynecological problems affecting women worldwide is endometrial disease. These illnesses affect people of all ages and have a substantial negative impact on the morbidity and mortality rates of mothers. The majority of female endometrial disease patients initially exhibit abnormal uterine bleeding (AUB). AUB thus supports the requirement for an immediate diagnosis. This is due to the large variety of endometrial disease histological patterns. Simple endometrial hyperplasia to more complicated conditions like endometrial cancer is among these lesions. Diagnosing most of these lesions requires taking an endometrial sample. For a conclusive identification of the lesions, the two most crucial sample techniques are curettage and endometrial biopsy. Women with this menstruation illness are affected from adolescence through postmenopause. AUB is characterized by variations in the amount of blood flow, length, frequency, or intermenstrual bleeding.
AIM: The purpose of this study is to examine different endometrial histomorphological patterns in patients with abnormal uterine bleeding from a range of age groups.
MATERIAL AND METHOD: This study looked back at patients who had presented to the Department of Pathology with AUB during that time. In this investigation, the pathology department examined 120 samples of endometrial curettage tissues with clinical symptoms of abnormal uterine hemorrhage for histological evaluation. Women presenting with AUB provided endometrial samples to the Department of Pathology via fractional curettage, endometrial biopsy, and dilatation and curettage (D and C). The Department of Pathology provided the histopathological reports on each of these instances, while the Department of Medical Records provided further information about the patients. Medical records were used to gather information on the patient's demographics, parity, gestational age if she was pregnant, indication, and histopathology results.
RESULTS: The study comprised 120 endometrial curetts in total. With a mean age of 40.4 years, the patients with AUB range in age from 18 to 79 years. The age range of 40 to 49 years old had the highest frequency of AUB. Proliferative endometrium was the most prevalent finding in women under 40, followed by secretory endometrium and disordered proliferative endometrium. A disorganized proliferation pattern was seen in 12 cases (10%), with the age groups of 30 to 39 and 40 to 49 years old showing the highest prevalence of this pattern. Four (3.4%) of the lesions were found to be malignant.
CONCLUSION: What makes up the largest percentage of histopathological findings are normal cyclic changes. On the other hand, hyperplasia and cancers are significant contributors to bleeding during and after menopause. Although the effectiveness of D&C in diagnosing premalignant and malignant cases is still dubious, its usage as a sampling method for AUB patients is still widely used. In order to rule out preneoplasia and cancer, patients experiencing abnormal uterine bleeding should have endometrial samples examined histopathologically. Physiological features such as proliferative endometrium, secretory endometrium, and monthly fluctuations were normal in patients without organic pathology.
KEYWORDS: Abnormal uterine bleeding, Histopathology, Endometrial hyperplasia and Carcinoma