Endometrial pathology in abnormal uterine bleeding

Abstract

Background: Abnormal uterine bleeding (AUB) is a common gynaecological complaint requiring histopathological evaluation for accurate diagnosis. Histopathological examination remains essential for diagnosing AUB and detecting premalignant and malignant lesions.

Methods: This prospective observational study was conducted in the Department of Pathology, Terna Medical College and Hospital, Navi Mumbai, over a period of two years from August 2022 to August 2024. The study was undertaken to evaluate the histopathological spectrum of endometrial lesions in patients presenting with AUB and to assess their age-wise distribution

Results: A total of 293 endometrial biopsies and hysterectomy specimens from patients presenting with AUB were studied. The majority of patients belonged to the 40-49 years age group (151cases, 51.7%). Non-organic (functional) causes constituted the majority of cases, accounting for 209 cases (71.6%), organic lesions were 83 cases (28.8%). Endometrial polyp was the most common organic lesion, observed in 36 cases (12.3%). Among the non-organic lesions, proliferative phase endometrium was the most common finding, accounting for 64 cases (21.9%). Disordered proliferative endometrium demonstrated a statistically significant association with age distribution (p=0.034), with maximum prevalence in women aged 40-49 years. Endometrial carcinoma showed a significant association with advancing age

Conclusions: The present study demonstrated that non-organic endometrial lesions with the highest incidence observed in the perimenopausal age group (40-49 years). Early detection of premalignant lesions, malignant lesions and helps in guiding appropriate patient management.