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Journal articles on the topic 'Endometrial pathology'
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Rajagopal, Indu, Beena Mary Thomas, and Vidyadhar N. K. Rama Rao. "Endometrial pathology in abnormal uterine bleeding." International Journal of Research in Medical Sciences 7, no. 10 (September 25, 2019): 3762. http://dx.doi.org/10.18203/2320-6012.ijrms20194306.
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Background: Abnormal uterine bleeding (AUB) is a common presenting symptom in gynecological outpatient department. Endometrial sampling could be used as the first diagnostic step in AUB. Aim of our study was to evaluate the endometrial causes of AUB and to observe the incidence of various pathology in different age groups.Methods: A study was conducted on 167 patients who presented with AUB, during the period from July 2015- January 2017.All endometrial curettage and hysterectomy specimens received in the Department of Pathology, Kannur Medical College during this period were included.Results: Maximum numbers of patients were in the perimenopausal age group and normal cycling endometrium was the commonest pattern observed (41.3%).Abnormal patterns noted were hyperplasia without atypia (20.9%), disordered proliferative pattern (16.1%) and endometrial carcinoma (1.7%).Conclusion: Histopathological examination of endometrium showed wide spectrum of lesions from normal endometrium to malignancy. Accurate analysis of endometrial sampling is important in the management of AUB.
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Elmore, Lynne W., Kelly Domson, Jonathan R. Moore, Michael Kornstein, and R. Tucker Burks. "Expression of c-Kit (CD117) in Benign and Malignant Human Endometrial Epithelium." Archives of Pathology & Laboratory Medicine 125, no. 1 (January 1, 2001): 146–51. http://dx.doi.org/10.5858/2001-125-0146-eockci.
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Abstract Background.—The proto-oncogene c-kit encodes a tyrosine kinase receptor (CD117) with a molecular weight of 145 kd. Previous studies, predominantly utilizing immunohistochemistry, have led to contradictory findings regarding the expression of CD117 in the endometrium. To help resolve this issue, we analyzed a series of benign and malignant endometrial tissues using both immunohistochemistry and Western blot analysis. Objective.—To examine the expression of CD117 in benign and malignant human endometrial tissues. Methods.—The expression of CD117 in 35 benign endometrial tissues (7 hyperplastic, 14 proliferative, 14 secretory) and 10 endometrioid carcinomas was investigated by immunohistochemistry (clone K45 monoclonal antibody). Immunoprecipitation (clone K69 monoclonal antibody) followed by Western blotting (clone K45 monoclonal antibody and clone 1.D9.3D6 monoclonal antibody) was performed to confirm CD117 expression. Results.—Fifty-seven percent of the hyperplasias, 93% of proliferative endometria, and 79% of secretory endometria immunostained positively for CD117. In benign endometria, epithelial staining tended to be more intense in the hyperplastic and proliferative endometria as compared to the secretory endometria, whereas endometrial stromal cells were not immunoreactive. Of the 10 frozen endometrial tissues analyzed by immunohistochemistry, 4 of 9 endometrioid carcinomas and a single case of an endometrioid polyp developing in association with a carcinoma expressed CD117. Immunoprecipitation followed by Western blot analysis confirmed expression of full-length CD117 in an endometrial polyp and carcinoma, and revealed a correlation between levels of immunoprecipitated CD117 and immunohistochemical staining intensity. Conclusions.—Benign and malignant endometrial tissues express CD117. Our data suggest (a) a possible relationship between estrogen and CD117 expression in benign endometrium and (b) potential involvement of this growth factor receptor in endometrial carcinogenesis.
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Czernobilsky, Bernard, and Beatriz Lifschitz-Mercer. "Endometrial pathology." Current Opinion in Obstetrics and Gynecology 9, no. 1 (February 1997): 52–56. http://dx.doi.org/10.1097/00001703-199702000-00012.
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Haller, H. "WS05: Endometrial pathology WS05-01Ultrasound in endometrial pathology." Ultrasound in Obstetrics and Gynecology 16 (October 2000): 11–12. http://dx.doi.org/10.1046/j.1469-0705.2000.00009-1-30.x.
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Terzic, Milan, Gulzhanat Aimagambetova, Jeannette Kunz, Gauri Bapayeva, Botagoz Aitbayeva, Sanja Terzic, and Antonio Simone Laganà. "Molecular Basis of Endometriosis and Endometrial Cancer: Current Knowledge and Future Perspectives." International Journal of Molecular Sciences 22, no. 17 (August 27, 2021): 9274. http://dx.doi.org/10.3390/ijms22179274.
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The human endometrium is a unique tissue undergoing important changes through the menstrual cycle. Under the exposure of different risk factors in a woman’s lifetime, normal endometrial tissue can give rise to multiple pathologic conditions, including endometriosis and endometrial cancer. Etiology and pathophysiologic changes behind such conditions remain largely unclear. This review summarizes the current knowledge of the pathophysiology of endometriosis and its potential role in the development of endometrial cancer from a molecular perspective. A better understanding of the molecular basis of endometriosis and its role in the development of endometrial pathology will improve the approach to clinical management.
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Pintican, Roxana, Vlad Bura, Marta Zerunian, Janette Smith, Helen Addley, Susan Freeman, Damiano Caruso, Andrea Laghi, Evis Sala, and Mercedes Jimenez-Linan. "MRI of the endometrium - from normal appearances to rare pathology." British Journal of Radiology 94, no. 1125 (September 1, 2021): 20201347. http://dx.doi.org/10.1259/bjr.20201347.
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MRI was recently included as a standard pre-operative diagnostic tool for patients with endometrial cancer. MR findings allow a better risk assessment and ultimately guides the surgical planning. Therefore, it is vital that the radiological interpretation is as accurate as possible. This requires essential knowledge regarding the appropriate MRI protocol, as well as different appearances of the endometrium, ranging from normal peri- and post-menopausal changes, benign findings (e.g. endometrial hyperplasia, polyp, changes due to exogenous hormones) to common and rare endometrium-related malignancies. Furthermore, this review will emphasize the role of MRI in staging endometrial cancer patients and highlight pitfalls that could result in the underestimation or overestimation of the disease extent.
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De Leon, Maria B., Wu Howard, and Giuseppe Del Priore. "Novel approach to outpatient endometrial biopsy to detect endometrial cancer." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e16522-e16522. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e16522.
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e16522 Background: Currently there is no consensus on the best device and technique for obtaining endometrial biopsies to rule out cancer. Outpatient methods available include aspiration devices (Pipelle) and disruption devices (Tao brush). This study evaluated a new device which combines Global endometrial Disruption using a brush with a built in suction Process (GDP-Tao). Methods: After IRB approval, endometrial specimens were collected using the GDP-Tao from fresh uteri after completion of hysterectomies. Endometrial pathology results from the new device were compared to the final hysterectomy diagnosis by blinded review. Results: Patients (n = 33) were 29-86 years old (median 56), 67% obese, 52% menopausal. Uterine sounds were 2.5-11cm (median 6.6 cm), weight 45-3500g (median 238g), 15% of cervical os were stenotic but all allowed the device to pass without other instrumentation with overall diagnostic rate of 91% (30/33) 15/15 pathologically confirmed malignant specimens were correctly identified by the new device including 2 GDP-Tao specimens with atypical hyperplasia (AH) and hysterectomy pathology with AH and focal adenocarcinoma. Classifying any atypia from the GDP-Tao as “positive” then the detection rate for malignancy was 100% (PPV). 11/11 samples were benign in GDP-Tao and final pathology. There were 3 non-diagnostic (ND) samples from GDP-Tao with final pathology of benign endometrium. One specimen was ND due to absence of tissue from prior endometrial ablation. There was one device result of “proliferative endometrium” with final pathology of focal complex atypical hyperplasia and one device result of “rare atypical cells” with final diagnosis of endometrial polyp. Sensitivity and specificity were 94% and 92%, and negative predictive value was 82% for the identification of both atypical hyperplasia and malignancy. When stratified by uterine size, benign or malignant, the results were similar. Conclusions: Our validation study showed encouraging data thatthis new endometrial sampling device, which combines tissue disruption and aspiration into a single process, provides a reliable mean of obtaining adequate sample to accurately detect endometrial cancer with a high negative and positive predictive value.
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Lyzikova, Yu A., and A. N. Lyzikov. "Hyperplastic processes in the endometrium of postmenopausal women." Health and Ecology Issues, no. 1 (May 1, 2021): 48–54. http://dx.doi.org/10.51523/2708-6011.2021-18-1-7.
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Objective: to specify indications for endometrial biopsy in postmenopausal women with endometrial pathology revealed by ultrasound, to study the structure of comorbidity, the parity of pregnancies and childbirth in patients with endometrial hyperplasia.Material and methods. We performed an observational retrospective case-control study. The study included 60 postmenopausal patients with endometrial pathology revealed by ultrasound referred for further endometrial biopsy. After the results of the histological examination of the endometrium had been obtained, 30 patients who had detected endometrial pathology were included in the study group, 30 patients with histologically normal endometrium were included in the comparison group.Results. In comparing clinical and anamnestic data, no statistically significant differences have been found between the groups. The comparison of the indices of the ultrasound study of the uterus has revealed a statistically significant M-echo value in patients with confirmed endometrial pathology — 10.00 (8.00; 13.00) mm, in the comparison group — 7.80 (6.00; 9.75) mm. If an M-echo value is > 7 mm with a sensitivity of 76.67 % and a specificity of 46.65%, endometrial pathology is likely to develop. The area under the curve (AUC) was 0.706 (95 % CI 0.574 — 0.816; p < 0.001).Conclusion. The obtained data determine an M-echo value more than 7 mm detected by ultrasound as an indication for endometrial biopsy in postmenopausal patients. If an M-echo value is from 5 to 7 mm and clinical manifestations are absent, dynamic observation with ultrasound control can be performed. No specific risk factors for the disease have been found in the postmenopausal patients with endometrial hyperplasia, which necessitates the search for the genetic markers of estrogen metabolic disorders.
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Quddus, M. Ruhul, Predrag Latkovich, William J. Castellani, C. James Sung, Margaret M. Steinhoff, Robert C. Briggs, and Roberto N. Miranda. "Expression of Cyclin D1 in Normal, Metaplastic, Hyperplastic Endometrium and Endometrioid Carcinoma Suggests a Role in Endometrial Carcinogenesis." Archives of Pathology & Laboratory Medicine 126, no. 4 (April 1, 2002): 459–63. http://dx.doi.org/10.5858/2002-126-0459-eocdin.
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Abstract Context.—Endometrioid carcinoma is often preceded by characteristic histopathologic lesions known as endometrial hyperplasia. Estrogen appears to be involved in the development of endometrioid carcinoma. Other mechanisms of endometrial carcinogenesis include mutations in p53 and PTEN tumor suppressor genes and overexpression of cyclin D1. However, the pattern of cyclin D1 expression is not well defined in normal, hyperplastic, neoplastic, and metaplastic endometrium. Design.—Cyclin D1 immunohistochemical analysis was used to evaluate 108 fixed, paraffin-embedded endometrial biopsy specimens and uterine resections obtained from 108 patients. Specimens included proliferative and secretory endometria, simple and complex hyperplastic lesions, and endometrioid adenocarcinoma. Normal and metaplastic surface epithelia were also evaluated independently of glandular morphologic features. Results.—Cyclin D1 was significantly overexpressed in glands with complex hyperplasia and endometrioid adenocarcinoma compared with proliferative or secretory endometrium and simple hyperplasia. Significant overexpression was also noted in papillary, syncytial, and squamous metaplasias compared with normal surface epithelium or epithelium with tubal metaplasia. Conclusion.—Overexpression of cyclin D1 increases from normal endometrium to hyperplasia and carcinoma, suggesting that it may play a role in endometrial carcinogenesis. Overexpression of cyclin D1 in endometrial glands was independent from overexpression of cyclin D1 in surface metaplastic epithelium.
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Nieberg, Roberta K., and Sharon L. Hirschowitz. "Malignant endometrial pathology." Current Opinion in Obstetrics and Gynecology 4, no. 4 (August 1992): 594–600. http://dx.doi.org/10.1097/00001703-199208000-00018.
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Basnet, Pritha, Achala Thakur, Ajay Agrawal, Sangeeta Bhandari, Sarita Sitaula, and Smriti Karki. "Correlation of Clinical Presentations with Endometrial Pathologies in Women Presenting with Abnormal Uterine Bleeding. A Prospective Descriptive Study." Birat Journal of Health Sciences 3, no. 1 (May 6, 2018): 354–56. http://dx.doi.org/10.3126/bjhs.v3i1.19757.
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Introduction: Abnormal uterine bleeding (AUB) is one of the common presenting symptoms in women attending gynaecology outpatient department and has remained one of the most frequent indications for hysterectomy in developing countries. Endometrial sampling is used as the first diagnostic step in AUB.Objectives: To correlate the clinical presentations with endometrial pathologies in women presenting with abnormal uterine bleeding.Methodology: This was a hospital based descriptive study carried out on one hundred and nineteen women who presented with AUB and planned for endometrial biopsy. Clinical profile of the patient was recorded and the histopathology of the sampled endometrial tissue was retrieved. Correlation of abnormal uterine bleeding with histopathology report was done using appropriate statistical test.Results: The mean age of presentation of women with abnormal uterine bleeding was 46.56 yrs ± 9.525. Irregular menstrual cycle was the commonest reason seeking treatment for AUB. The commonest histopathology among women who underwent endometrial biopsy was secretory endometrium (39.5%). Other causes identified were proliferative endometrium (21.8%), mucus flakes with hemorrhage (16%), disordered proliferative endometrium (10%), pill endometrium (5%) ,endometritis (5.9%), endometrial carcinoma (1.7%),endometrial hyperplasia without atypia (1.7%).Conclusion: The nature of endometrial pathology is varied across the entire spectrum of women presenting with abnormal uterine bleeding. Knowledge of endometrial pathology helps in directing specific management and can provide better care to women presenting with abnormal uterine bleeding. BJHS 2018;3(1)5 : 354-356
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Dr.Shilpa.M.D, Dr Shilpa M. D., and Dr Subramanya Dr. Subramanya. "Study of Endometrial Pathology in Abnormal Uterine Bleeding." International Journal of Scientific Research 3, no. 8 (June 1, 2012): 490–92. http://dx.doi.org/10.15373/22778179/august2014/160.
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Iupatov, E. Iu, I. G. Mustafin, T. E. Kurmanbaev, R. M. Nabiullina, K. M. Atayants, A. A. Shmidt, and E. V. Frederiks. "Local hemostasis disorders underlying endometric pathology." Obstetrics, Gynecology and Reproduction 15, no. 4 (September 9, 2021): 430–40. http://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2021.214.
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Introduction. Hemostasis is an equilibrium system that performs 2 bidirectional tasks: on the one hand, it prevents bleeding development, whereas on the other hand, it counters thrombogenesis. Shifting the balance leads to development of various complications, and also serves as a key link in the pathogenesis of a number of diseases. Currently, the issue of changing the state of local endometrial hemostasis in various pathologies is of high priority. Unfortunately, publications available on this problem are limited.Aim: to conduct a literature search and systematize the data analysis to expand understanding regarding a role of local hemostasis disorders in formation of endometrial pathology.Materials and Methods. There has been performed a systematic analysis of full-text scientific reviews and original articles published in English and Russian in the modern literature. The review includes the 1995-2020 data published in the international abstract and bibliographic databases eLibrary, Google Scholar, Web of Science, Scopus and PubMed/MEDLINE.Results. Hemostatic changes in the endometrium that occur under the influence of estrogens and progesterone, and create a local hemostatic environment, which disturbance contributes to emergence of various endometrial pathologies, are described. It was found that for the physiological course of pregnancy, complex changes in the local hemostasis are necessary, which are aimed at facilitating the processes of chorionic invasion and maintaining metabolic processes in the mother-fetus interface, whereas alteration of the aforementioned processes contributes to development of abnormal chorionic invasion as the basis for development of insufficient placental function, preeclampsia (PE), and pregnancy termination. Moreover, there have been summarized the data on key changes in the state of local endometrial hemostasis that play a role in the pathogenesis of endometriosis, as well as underlying abnormal uterine bleeding (AUB).Conclusion. Current research publications provide sparse evidence that the state of the local hemostasis in the endometrium is an important aspect of the physiological course of the menstrual cycle, as well as formation of endometrial pathology. In this review, it is shown that local hemostasis is inextricably linked with the state of the systemic hemostasis, but at the same time, its functioning depends on the level of hormones estrogens and progesterone. Impaired function of local endometrial hemostasis is an important aspect of the pathogenesis of miscarriage, as well as conditions such as PE, endometriosis, AUB.
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Benyuk, V. O., V. M. Goncharenko, and T. R. Nykoniuk. "Modern determinants of endometrium hyperplastic processes pathogenesis." HEALTH OF WOMAN, no. 5(111) (June 20, 2016): 137–42. http://dx.doi.org/10.15574/hw.2016.111.137.
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The objective: to еxplore the relationship between the activity of endometrial proliferation and the state of the local immune response in the uterus in the conditions berprestasi process. Patients and methods. Examined 228 women of reproductive and perimenopausal age with endometrial pathology using ultrasound and then performing hysteroresectoscopy. Determination of the concentrations of the cytokines IL-1, IL-2, IL-6 and TNF was performed by solid phase ELISA. Results. Found a trend that confirms the loss of sensitivity to hormones at the stage of malignancy of the endometrium and can be used as diagnostic determinants in determining the nature of intrauterine pathology and criterion of the effectiveness of conservative therapy. Conclusion. Improving etiopatogenetice approach to the therapy of hyperplastic proce.sses of endometrium with determination of receptor phenotype of the endometrium is a research direction in modern gynecology, which will help to improve the results of treatment and prevention of intrauterine pathology. Key words: endometrial hyperplasia,the receptors for progesterone and estrogen, immunohistochemical method.
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Gibson, Douglas A., Ioannis Simitsidellis, Frances Collins, and Philippa T. K. Saunders. "Androgens, oestrogens and endometrium: a fine balance between perfection and pathology." Journal of Endocrinology 246, no. 3 (September 2020): R75—R93. http://dx.doi.org/10.1530/joe-20-0106.
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The endometrium is a complex multicellular tissue that is exquisitely sensitive to the actions of sex steroids synthesised in the ovary (endocrine system). Recent studies have highlighted a previously under-appreciated role for local (intracrine) metabolism in fine-tuning tissue function in both health and disease. In this review we have focused on the impact of oestrogens and androgens on endometrial function summarising data from studies on normal endometrial physiology and disorders including infertility, endometriosis and cancer. We consider the evidence that expression of enzymes including aromatase, sulphatase and AKR1C3 by endometrial cells plays an important role in tissue function and malfunction and discuss results from studies using drugs targeting intracrine pathways to treat endometrial disorders. We summarise studies exploring the spatial and temporal expression of oestrogen receptors (ERalpha/ESR1, ERbeta/ESR2 and GPER) and their role in mediating the impact of endogenous and synthetic ligands on cross-talk between vascular, immune, epithelial and stromal cells. There is a single androgen receptor gene and androgens play a key role in stromal-epithelial cross-talk, scar-free healing of endometrium during menstruation and regulation of cell proliferation. The development of new receptor-selective drugs (SERMs, SARMs, SARDs) has reinvigorated interest in targeting receptor subtypes in treatment of disorders including endometriosis and endometrial cancer and some show promise as novel therapies. In summary, understanding the mechanisms regulated by sex steroids provides the platform for improved personalised treatment of endometrial disorders as well as novel insights into the impact of steroids on processes such as tissue repair and regeneration.
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S., Anitha, Pooja G., and Sowmya D. "Study of histopathological patterns of endometrium in abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 4 (March 24, 2021): 1401. http://dx.doi.org/10.18203/2320-1770.ijrcog20211110.
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Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out- patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. And also, to observe the incidence of various endometrial pathology in different age groups presenting with abnormal uterine bleeding.Methods: A one-year prospective study conducted in the department of obstetrics and gynaecologist in A. J. institute of medical sciences and research centre which included 200 cases of clinically diagnosed AUB patients. Histopathological examination of endometrial biopsies specimens was done, followed by clinical correlation.Results: The most common age group presenting with AUB was 41-50 years (43.84%). The commonest pattern in these patients was normal cycling endometrium (42.32%). The commonest pathology irrespective of the age group was disordered proliferative pattern (26.15%). Other causes identified atrophic endometrium (11.5%), benign endometrial polyp (5.38%), endometrial hyperplasia (5.41%), carcinomas (0.79%) and chronic endometritis (1.54%).Conclusions: The knowledge of endometrial pattern in a case of AUB helps to decide a plan of management. Endometrial sampling plays a very important role in management of AUB, especially in the age group of more than 40 years; i.e., the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest.
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Varghese, Jessy, Jeyashambavi J., and Deepa S. "Study of endometrial pathology in women with abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 12 (November 26, 2018): 5037. http://dx.doi.org/10.18203/2320-1770.ijrcog20184962.
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Background: Abnormal uterine bleeding is one of the most common complaint that reproductive age women bring to their clinicians. Causes are varied and study of endometrium by dilatation and curettage with histopathological examination is an important aspect of treating patients with Abnormal uterine bleeding (AUB). The present study was done for evaluation of the histopathology of the endometrium for identifying endometrial causes of AUB.Methods: A prospective study was conducted over a period of one year from July 2017 to July 2018 in the department of Obstetrics and Gynaecology in collaboration with the department of Pathology at Aarupadai Veedu Medical College, Puducherry. A complete clinical history, complete clinical examination, laboratory investigations, pelvic scan and endometrial biopsy were done to diagnose causes of AUB.Results: A total of 152 cases are included. The age of the patients having AUB was ranging from 21 to 70 years. AUB was more common the age group in the age group 41-50 years (49%) followed by 31-40 years (36%). Majority were multiparous (74%). Menorrhagia (61%) was the commonest presentation. Majority of the cases showed a disordered proliferative endometrial pattern (34.2%), followed by secretory pattern (25%). 9.8% had polyp and 1.3% showed simple hyperplasia and 0.62% revealed complex hyperplasia without atypia and carcinoma endometrium.Conclusions: Abnormal uterine bleeding was more common in the perimenopausal age group and majority had disordered proliferative endometrium and secretory changes. Endometrial sampling followed by histopathological examination helps us to diagnose the underlying pathology and will help in treating the patients appropriately including ruling out premalignant and malignant conditions of the uterus.
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I, Sandhya, Manjushree Prabhu P, Purnima S Rao, and Sameeksha Alwa. "A descriptive study of Endometrial Biopsies in perimenopausal women having Abnormal uterine bleeding." IP Archives of Cytology and Histopathology Research 6, no. 3 (September 15, 2021): 203–5. http://dx.doi.org/10.18231/j.achr.2021.045.
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Abnormal uterine bleeding (AUB) is one of the commonest symptom with which the perimenopausal female visits the gynaecologist accounting for over 70% of all gynecological consultations in that age group. The clinical presentation of AUB can range anywhere menorrhagia, polymenorrhea, polymenorrhagia, metrorrhagia, and menometrorrhagia. Though biopsy is the gold standard it is an invasive procedure and hence often an Ultrasound is used to evaluate the pathology of the endometrium routinely hence, we decided to study the accuracy between radiological ET thickened and its usefulness in detecting endometrial pathology. This study was carried out in the Department of Pathology at AJIMS, Mangalore for a period of 2 years. The sample included endometrial biopies and hysterectomy specimens of perimenopausal women for AUB. The ultrasonographic findings and Histopathological (HPE) reports were analysed. Among 101 cases for AUB, 67 cases were diagnosed as non secretory endometrium. Out of these 67 cases, 49 cases were associated with fibroids. Out of the rest of the AUB cases, 31 of them were diagnosed to have endometrial hyperplasia and 3 cases were diagnosed to have endometrial carcinoma. USG thickness of 17(54%) out of 31 endometrial hyperplasia cases were abnormal. Radiological and pathological evaluation were concordant with diagnosis of AUB associated with fibroids. However only 54% of the endometrial hyperplasia were found to have abnormal endometrial thickness. Radiological evaluation of endometrial thickness is not concordant in 46 % of the cases. This implies that histopathological examination is gold standard diagnostic tool for endometrial abnormalities in perimenopausal women.
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Reijnen, Casper, Nicole C. M. Visser, Johan Bulten, Leon F. A. G. Massuger, Louis J. M. van der Putten, and Johanna M. A. Pijnenborg. "Diagnostic accuracy of endometrial biopsy in relation to the amount of tissue." Journal of Clinical Pathology 70, no. 11 (April 7, 2017): 941–46. http://dx.doi.org/10.1136/jclinpath-2017-204338.
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AimsFor the diagnostic workup of postmenopausal bleeding, histological examination of the endometrium is frequently performed. Failure of endometrial sampling due to insufficient material is often reported but objective criteria for quality assessment of endometrial biopsies are lacking. The aim of the present study is to evaluate the association between the amount of tissue obtained by endometrial sampling and the diagnostic accuracy, and to establish a cut-off level for a minimal amount of tissue required for a conclusive diagnosis.MethodsFor this retrospective cohort study, clinicopathological data and Pipelle endometrial sampling slides of 139 patients who were treated with hysterectomy were collected. The surface of evaluable endometrial tissue was measured by means of structured digital assessment. The correlation between the predictive values in relation to the endometrial tissue surface was calculated for different cut-off values.ResultsThe median endometrial tissue surface was 4.7 mm2 (range 0.4–156.4) for benign endometrium, 27.8 mm2 (range 0.0–208.4) for premalignant endometrium and 43.8 mm2 (range 0.0–223.6) for malignant endometrium. There was a significant association between the endometrial tissue surface and the correctness of diagnosis. A minimal endometrial tissue surface of 35 mm2 could be defined, for positive and negative predictive values of 92.6% and 85.7%, respectively.ConclusionsThe diagnostic accuracy of Pipelle endometrial sampling is associated with the amount of endometrial tissue surface, with a minimal cut-off value of 35 mm2 required to classify an endometrial sample as conclusive. Quantification of endometrial tissue can contribute to standardisation of quality assessment of endometrial samplings.
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Nicholas, Kenney. "Handbook of Endometrial Pathology." Obstetrician & Gynaecologist 9, no. 2 (April 2007): 139. http://dx.doi.org/10.1576/toag.9.2.139.27321.
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Jaworski, Richard. "Handbook of Endometrial Pathology." Pathology 38, no. 4 (August 2006): 384. http://dx.doi.org/10.1016/s0031-3025(16)39685-4.
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Ruiz-Velasco, Victor, Guadalupe González Alfani, Leticia Pliego Sánchez, and Marcela Alamillo Vera. "Endometrial pathology and infertility." Fertility and Sterility 67, no. 4 (April 1997): 687–92. http://dx.doi.org/10.1016/s0015-0282(97)81367-2.
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Sherman, Mark E., and Steven G. Silverberg. "Advances in Endometrial Pathology." Clinics in Laboratory Medicine 15, no. 3 (September 1995): 517–43. http://dx.doi.org/10.1016/s0272-2712(18)30317-2.
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LANE, BARTON F., and JADE J. WONG-YOU-CHEONG. "Imaging of Endometrial Pathology." Clinical Obstetrics and Gynecology 52, no. 1 (March 2009): 57–72. http://dx.doi.org/10.1097/grf.0b013e318196153c.
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Lane, Barton F., and Jade J. Wong-You-Cheong. "Imaging of Endometrial Pathology." Topics in Magnetic Resonance Imaging 21, no. 4 (July 2010): 237–45. http://dx.doi.org/10.1097/rmr.0b013e31823d8045.
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Sankareswari, R., and Ramya Sreevarshni Shunmugha Sundharam. "Histopathological features of endometrium in those with symptoms suggestive of female genital tuberculosis." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (April 28, 2018): 1827. http://dx.doi.org/10.18203/2320-1770.ijrcog20181911.
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Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of female genital TB is not complete without tissue diagnosis. The aim of the present study was to find out the histopathological pattern of theendometrium in those with symptoms suggestive of genital tuberculosis.Methods: A random sample of 200 female OPD patients with symptoms suggestive of FGTB attending to the Obstetrics and Gynaecology OPD in a tertiary care hospital at Ariyur, Puducherry were subjected to endometrial curettage and histological characteristics of endometrial biopsy material was assessed.Results: Endometrial histopathology revealed proliferative endometrium (60.5%, n=121), secretary endometrium (25.5%, n=51) and menstrual endometrium (9%, n=18) in majority. Chronic endometritis (3%, n=6), Simple hyperplasia without atypia (1%, n=2), atrophic (0.5%, n=1) and inert endometrium (0.5%, n=1) were other abnormalities reported.Conclusions: Histopathological features of endometrium in those with suggestive symptoms of female genital TB are variable and non-specific.
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Bindroo, Simridhi, Monika Garg, and Tajinder Kaur. "Histopathological spectrum of endometrium in abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 9 (August 27, 2018): 3633. http://dx.doi.org/10.18203/2320-1770.ijrcog20183767.
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Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding.
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Mathew, Sunitha Mary, and Pramod Thomas. "A prospective study on the efficacy of Pipelle biopsy to diagnose endometrial pathology in patients with abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 11 (October 23, 2019): 4238. http://dx.doi.org/10.18203/2320-1770.ijrcog20194608.
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Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.
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Begum, Noor Ayesha, Lokesh Chandra H. C., and Ravindra S. Pukale. "Evaluation of endometrial thickness with transvaginal ultrasonography in perimenopausal women presenting with abnormal uterine bleeding and correlation with its histopathological findings." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 11 (October 23, 2019): 4496. http://dx.doi.org/10.18203/2320-1770.ijrcog20194882.
Full textAbstract:
Background: Abnormal uterine bleeding is the most common presenting menstrual complaint in women of perimenopausal age group. Most frequently used diagnostics tests to investigate the causes of abnormal bleeding are Transvaginal ultrasonography (TVS) and endometrial biopsy. Uterine curettage is an invasive procedure and is performed with anaesthesia. TVS is a non-invasive method that has been used to evaluate the endometrium and uterine cavity. The objectives of this study were to measure and evaluate the role and accuracy of endometrial thickness by transvaginal ultrasonography study to detect endometrial pathology in perimenopausal women presenting with Abnormal Uterine Bleeding. To correlate the transvaginal sonographic results with the Histopathological findings to discriminate normal from pathological endometrium.Methods: Prospective study including 150 perimenopausal women with abnormal uterine bleeding. Endometrial thickness was measured by TVS and then D and C was performed for all the patients.Results: Out of 150 women, 128 (85.3%) had normal and 22 (15%) had an abnormal endometrium. 43.3% were of 41-45 years and 65.3% patients presented with complaint of heavy menstrual bleeding. Majority of the patients in the study group were para 2 or more. Fibroid uterus (24%) was the commonest uterine pathology detected on TVS. 53.3% of patients had endometrial thickness in the range 10-14.9 mm. Most common finding on HPE was secretory endometrium (44.6%). Endometrial carcinoma was found in 3%. Endometrial thickness <14mm was associated with least abnormal endometrial pathology.Conclusions: Endometrial thickness of less than 14 mm need not be indicated for D and C in perimenopausal abnormal uterine bleeding. In perimenopausal women with AUB, TVS should be the investigation of choice due to its convenience, accuracy and non- invasiveness.
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Dzyubiy, Tatyana Ivanovna, Anna Eduardovna Protasova, Grigoriy Aleksandrovich Raskin, Anna Alekseyevna Tsypurdeyeva, and Natalya Igorevna Tapilskaya. "Immunocytochemistry in diagnostics of endometrial precancer." Journal of obstetrics and women's diseases 62, no. 5 (September 15, 2013): 35–40. http://dx.doi.org/10.17816/jowd62535-40.
Full textAbstract:
Use of the method liquid-based cytology with next immunocytochemical study of endometrium is expedient for the differential diagnosis of endometrial pathology processes. The level of the gene PTEN and steroid receptors expression is higher in cases of simple hyperplasia and hyperplasia without atypia. Increase of the markers p53 and Ki67 expression was found only by atypical endometrial hyperplasia. Positive reaction on CD138 determines the inflammatory process.
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Fadare, Oluwole, Lihui Qin, Maritza Martel, and Fattaneh A. Tavassoli. "Pathology of the NovaSure (Radio-Frequency) Impedance-Controlled Endometrial Ablation System." Archives of Pathology & Laboratory Medicine 129, no. 9 (September 1, 2005): 1175–78. http://dx.doi.org/10.5858/2005-129-1175-potnri.
Full textAbstract:
Abstract The widespread use of increasingly novel diagnostic and neoadjuvant therapeutic modalities necessitates that contemporary pathologists familiarize themselves with the spectrum of tissue derangements that may be seen in the eventual surgical specimens. In the management of endometrial lesions, for example, a variety of endometrial ablation technologies, such as cryosurgery, balloon therapy, microwave, hot circulating saline, and bipolar impedance technology, have been introduced in the past decade and are being utilized with increasing frequency. We describe herein pathologic changes associated with one such technology, the NovaSure impedance-controlled endometrial ablation system. The US Food and Drug Administration approved NovaSure in 2001 for ablation of the endometrial lining in premenopausal women with menorrhagia. The ablation is accomplished by the delivery of radio-frequency energy for a period of approximately 90 seconds through a device inserted transcervically into the endometrial cavity. Our patient, a 54-year-old with menorrhagia, had undergone the NovaSure ablative treatment 38 days prior to her eventual hysterectomy. The resultant changes were quite distinctive: in a uterine wall that was 20 to 30 mm thick, a 3- to 6-mm-thick, hyalinized, subendometrial bandlike zone was apparent throughout the uterus even on macroscopic examination of the slides. This zone was sharply demarcated from the subjacent myometrium and from the endometrium; the latter displayed severe stromal fibrosis, some myxoid change, and sparse glands that were largely confined to the basalis. Paradoxically, scattered aggregates of stromal cells in the endometrium remained relatively viable. Adenomyotic aggregates and leiomyomata in the myometrium beneath the hyalinized zone were unaffected by this treatment. Practitioners evaluating hysterectomy specimens should be aware of changes such as those described herein, not only to better understand the specimens they evaluate but to avoid potentially misinterpreting grotesque alterations caused by benign processes.
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Maruyama, Tetsuo, Hirotaka Masuda, Masanori Ono, Takashi Kajitani, and Yasunori Yoshimura. "Human uterine stem/progenitor cells: their possible role in uterine physiology and pathology." REPRODUCTION 140, no. 1 (July 2010): 11–22. http://dx.doi.org/10.1530/rep-09-0438.
Full textAbstract:
The human uterus mainly consists of the endometrium and the outer smooth muscle layer termed the myometrium. The uterus harbours the exceptional and remarkable regenerative ability responsible for cyclical regeneration and remodelling throughout the reproductive life. The uterus must swiftly and cooperatively enlarge to hold the growing foetus during pregnancy. Furthermore, the endometrium, in particular the functionalis layer, must also regenerate, differentiate and regress with each menstrual cycle under hormonal control. Endometrial regeneration from the basal layer is thought to contribute to replacement of the functionalis layer followed by its slough off during menses and parturition. These morphological and functional features of human endometrium can be reproduced in murine models in which severely immunodeficient mice are xenotransplanted with dispersed human endometrial cells under the kidney capsule. The uterine myometrium possesses the similar plasticity of the endometrium. This is demonstrated by multiple cycles of pregnancy-induced enlargement and regression after parturition. It is likely that regeneration and remodelling in the female reproductive tract are achieved presumably through endometrial and myometrial stem cell systems. Recent evidence now supports the existence of these stem cell systems in humans. Here, we will review our current understanding of uterine stem/progenitor cells. We also propose a novel hypothetical model in which stem cell activities explain the physiological remodelling and regeneration of the human uterus and the pathogenesis of gynaecological diseases such as endometriosis.
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Noor, Nusrat, Rabiah Anwar, Rabia Akbar, Ghazala Sadaf, and Khan M. Yaqub. "Assessing the Efficacy of Pipelle Sampling as Outpatient Diagnostic Test in a Tertiary Care Hospital-Rawalpindi, 2020." Journal of Rawalpindi Medical College 24, no. 4 (December 30, 2020): 348–52. http://dx.doi.org/10.37939/jrmc.v24i4.1451.
Full textAbstract:
ABSTRACT
Objective:
To assess the effectiveness and enlist clinical factors, which may affect effectiveness of Pipelle sampling in diagnosing endometrial pathology in patients with abnormal uterine bleeding and Post-menopausal Bleeding.
Study Design:
‘Analytical Cross-Sectional’ study.
Place and duration:
Gynecology Department at Combined Military Hospital Rawalpindi, in collaboration with Histo-Pathology Department, of six months duration i.e. from 1st December 2019 to 31st May 2020.
Patients and methods:
100 female patients of outpatient department with presenting complaints of either abnormal or post-menopausal bleeding were included in the study in the specified time frame. After informed written consent, Pipelle endometrial sampling was done on outpatient basis, and by consecutive sampling technique using lottery method, sample was sent for histopathological evaluation. Evaluated factors studied were: indications for the procedure, age, parity, age of menarche.
Results:
Of the total patients evaluated, 91% (n=100) were non-malignant, while 4% (n=100) were malignant. Inadequate tissue was obtained in 5% samples. Most common histopathological findings among reproductive age group were Proliferative and Secretory phase endometrium 64% (n=100). While in Post-menopausal age group 4% (n=100) were Endometrial carcinoma on histopathology. Inadequate tissue samples 5% (n=100) were noted among the Post-menopausal group. 6% samples showed endometrial hyperplasia. Pipelle Endometrial Sampling had sensitivity and specificity, in diagnosing the endometrial pathologies is summarized in Table 3.
Conclusion:
Pipelle Endometrial Sampling is an effective, safe, simple and acceptable procedure for diagnosing endometrial pathology. It is cost effective requiring no anesthesia with high sensitivity and specificity for detecting endometrial pathology.
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Noor, Nusrat, Rabiah Anwar, Rabia Akbar, Ghazala Sadaf, and Khan M. Yaqub. "Assessing the Efficacy of Pipelle Sampling as Outpatient Diagnostic Test in a Tertiary Care Hospital-Rawalpindi, 2020." Journal of Rawalpindi Medical College 24, no. 4 (December 30, 2020): 348–52. http://dx.doi.org/10.37939/jrmc.v24i4.1451.
Full textAbstract:
ABSTRACT
Objective:
To assess the effectiveness and enlist clinical factors, which may affect effectiveness of Pipelle sampling in diagnosing endometrial pathology in patients with abnormal uterine bleeding and Post-menopausal Bleeding.
Study Design:
‘Analytical Cross-Sectional’ study.
Place and duration:
Gynecology Department at Combined Military Hospital Rawalpindi, in collaboration with Histo-Pathology Department, of six months duration i.e. from 1st December 2019 to 31st May 2020.
Patients and methods:
100 female patients of outpatient department with presenting complaints of either abnormal or post-menopausal bleeding were included in the study in the specified time frame. After informed written consent, Pipelle endometrial sampling was done on outpatient basis, and by consecutive sampling technique using lottery method, sample was sent for histopathological evaluation. Evaluated factors studied were: indications for the procedure, age, parity, age of menarche.
Results:
Of the total patients evaluated, 91% (n=100) were non-malignant, while 4% (n=100) were malignant. Inadequate tissue was obtained in 5% samples. Most common histopathological findings among reproductive age group were Proliferative and Secretory phase endometrium 64% (n=100). While in Post-menopausal age group 4% (n=100) were Endometrial carcinoma on histopathology. Inadequate tissue samples 5% (n=100) were noted among the Post-menopausal group. 6% samples showed endometrial hyperplasia. Pipelle Endometrial Sampling had sensitivity and specificity, in diagnosing the endometrial pathologies is summarized in Table 3.
Conclusion:
Pipelle Endometrial Sampling is an effective, safe, simple and acceptable procedure for diagnosing endometrial pathology. It is cost effective requiring no anesthesia with high sensitivity and specificity for detecting endometrial pathology.
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Korniyenko, S. M. "Somatic status of the patients with different forms of endometrial pathology in late reproductive age and premenopausal period." HEALTH OF WOMAN, no. 3(119) (May 3, 2017): 93–102. http://dx.doi.org/10.15574/hw.2017.119.93.
Full textAbstract:
The objective: to study the relationship of extragenital pathology and pathology of the endometrium in women of late reproductive and premenopausal age. Patients and methods. In an observational cross-sectional study by a solid sample included 325 women 35–55 years old, average age 41.1±0.27 years old, suffering from various types of pathology of the endometrium. The survey included a study of complaints, anamnesis, complete physical and hysteroscopic examination. Results. Based on these data, it can be concluded relatively high prevalence of somatic diseases among women with PE in the late reproductive and premenopausal age. Almost 3/4 of cases examined in this study, there was at least one of extragenital diseases. In addition, the often observed multiple extragenital diseases: one-third of patients suffered two or three extragenital diseases, and every ninth observed four or more extragenital diseases. Moreover, multiple extragenital diseases associated with endometrial hyperplasia rather than with endometritis, endometrial polyps or synechiae, and hyperplasia with atypia, they met 2.2 times more often than in other forms of pathology of the endometrium. In the structure of genital comorbid factors associated with an increased incidence of somatic certainly dominated uterine fibroids and ovarian cysts. In our study, it is in respect of uterine fibroids showed the greatest number of significant relationships. Conclusion. High associativity extragenital predictors and uterine pathology in late reproductive and premenopausal age indicates the need to change the treatment paradigm fragmented, focused on major diseases and easy to miss the sight of the significant impact of comorbidity on the overall health and quality of life of the patient. Key words: endometrial pathology, late reproductive age, premenopausal, extragenital pathology.
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Шарифулин, Эльдар, Eldar Sharifulin, Махарам Шарифулин, Makharam Sharifulin, Лариса Сутурина, and Larisa Suturina. "ENDOMETRIAL MARKERS OF POLYCYSTIC OVARY SYNDROME (A LITERATURE REVIEW)." Acta biomedica scientifica 2, no. 5 (January 18, 2018): 21–27. http://dx.doi.org/10.12737/article_5a3a0d6a897224.40594850.
Full textAbstract:
Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women and has a significant impact on
various aspects of their health and the quality of life. The epidemiology of PCOS is well understood, while the preva-
lence of this syndrome depends on diagnostic criteria used, the characteristics of the population sample, and vary from
6–10 % to 15 % and higher. A number of studies suggest that the endometrium in women with PCOS differs from the
normal endometrium morphologically and functionally. PCOS is associated with infertility problems, higher incidence
of pregnancy complications and with increased risk of endometrial cancer, especially when obesity is present.
The purpose of this review was to systematize the available data on molecular markers of endometrial pathology as-
sociated with PCOS.
The information search was conducted using Internet resources (PubMed, EMBASE); literature sources for the period
1992–2016 were analyzed. Although the available information on the pathology of the endometrium is inconsistent,
as a result of the analysis of published data, several mechanisms of endometrial disorders characteristic of PCOS have
been identified: changes of hormonal effects (changes in hormone receptor expression, HOXA gene expression, changes
in the synthesis of sex hormone binding globulin, enzymes involved in the metabolism of sex hormones in situ in the
endometrium), hyperinsulinemia and disturbance of the glucose transport system, ratio of proinflammatory and anti-
inflammatory factors.
Authors conclude that the majority of analyzed studies report an increased prevalence of histologically confirmed
hyperplasia or endometrial cancer in women with PCOS. However, there are no clinical guidelines and approaches to
prognosis of endometrial changes women with PCOS. It is still unclear if endometrial biopsy is necessary for all women
with PCOS. The clinical significance of endometrial markers requires further investigation.
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Antero, Maria Facadio, Ayse Ayhan, James Segars, and Ie-Ming Shih. "Pathology and Pathogenesis of Adenomyosis." Seminars in Reproductive Medicine 38, no. 02/03 (May 2020): 108–18. http://dx.doi.org/10.1055/s-0040-1718922.
Full textAbstract:
AbstractAdenomyosis represents a unique pathophysiological condition in which normal-appearing endometrial mucosa resides within myometrium and is thus protected from menstrual shedding. The resulting ectopic presence of endometrial tissue composed of glands and stroma is thought to affect normal contractile function and peristalsis of uterine smooth muscle, causing menometrorrhagia, infertility, and adverse obstetric outcomes. Since the first description of adenomyosis more than 150 years ago, pathologists have studied this lesion by examining tissue specimens, and have proposed multiple explanations to account for its pathogenesis. However, as compared with endometriosis, progress of adenomyosis research has been, at best, incremental mainly due to the lack of standardized protocols in sampling tissue and a lack of consensus diagnostic criteria in pathology practice. Despite these limitations, recent advances in revealing the detailed anatomy and biology of eutopic endometrium offer an unprecedented opportunity to study this common but relatively understudied disorder. Here, we briefly summarize the pathological aspects of adenomyosis from an historical background, and discuss conventional morphology and recent tissue-based molecular studies with a special emphasis on elucidating its tissue of origin from a pathologist's perspective. We also discuss unmet needs in pathology studies that would be important for advancing adenomyosis research.
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Galan, Mark, Young Bae Kim, and Jonathan L. Hecht. "Does Physiologic Breakdown Mask Significant Pathology in Endometrial Biopsies? A Retrospective Case-Control Study." Archives of Pathology & Laboratory Medicine 130, no. 12 (December 1, 2006): 1847–49. http://dx.doi.org/10.5858/2006-130-1847-dpbmsp.
Full textAbstract:
Abstract Context.—Adequacy criteria for endometrial biopsy samples do not exist. Objective.—To assess the sensitivity of endometrial sampling for detecting neoplasia in the setting of extensive glandular and stromal breakdown. Design.—Retrospective case-control study. Surgical pathology records between 1996 and 2005 at Beth Israel Deaconess Medical Center (Boston, Mass) were searched for endometrial samples with diagnoses containing the key words “menstrual” or “extensive breakdown.” Hospital records for these women were parsed for demographics, clinical indications, and follow-up with rebiopsy within 6 months. Age cutoffs enriched the population for women at higher risk for carcinoma. A control group, consisting of 2 age-matched control patients for each test patient, was also studied; each control patient had an endometrial sample taken within a 6-month period and was not diagnosed with extensive breakdown, menstrual endometrium, or neoplasia on initial sampling. Results.—Fifty-four cases were identified. The primary biopsy reports had benign descriptive diagnoses (ie, proliferative, secretory, polyp). Follow-up biopsies showed benign pathology in all cases and specific causes of bleeding—including polyp, leiomyoma, or endometritis—in 28 (52%) of 54. In the control group, neoplasia was found in 2 of the 108 follow-up biopsies. Only 5 other controls had specific diagnoses; all were polyps. Conclusions.—Extensive breakdown or menstrual-pattern endometrium may mask other specific benign pathologies but does not commonly mask cancer.
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AbdullGaffar, Badr, and Amal AlMulla. "Endometrial Calcifications." International Journal of Surgical Pathology 28, no. 6 (March 1, 2020): 590–99. http://dx.doi.org/10.1177/1066896920909425.
Full textAbstract:
Benign endometrial calcifications with or without bone fragments are uncommon clinicopathologic findings. They can be detected during pelvic ultrasonography or as incidental pathologic findings. They have been found to be associated with infertility and menstrual anomalies in young adult patients and in symptomatic postmenopausal women with endometrial atrophy and endometrial polyps. Its exact etiology is unknown, its pathogenesis is controversial, and its clinical importance is not fully validated. We performed a retrospective review study over 7 years and found 11 (0.4%) cases of benign endometrial calcifications. The mean patient age was 45.2 years (range = 20-66 years). All of the women complained of menstrual abnormalities and 4 complained of infertility. Six had a previous procedure of abortion, 2 had oral contraceptive pills, and 4 a course of progesterone therapy. Their size and morphology varied from heterogeneous microcalcifications of variable appearances, shattered glassy chunks to detached bones. Four cases were associated with endometrial polyps, 1 with a placental site nodule, 1 with chronic endometritis, and 1 with endometrial hyperplasia. Most showed secretory endometrial tissue and ciliated cell metaplasia. Two cases showed atrophic endometrium. Etiology and pathogenesis are multifactorial and miscellaneous. Progesterone may play a role. Heterogeneous histomorphologic patterns may carry potential pitfalls. Pathologic recognition is clinically important to reassure clinicians in symptomatic postmenopausal women, alert gynecologists to a treatable albeit rare cause of infertility in younger women, and assist in patients’ counselling. We also included cases of calcifications associated with endometrial malignancies to compare and contrast malignant endometrial calcifications with benign endometrial calcifications.
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Zamurovic, Milena, Pavle Srbinovic, and Jovana Petrovic. "Role of hydrosonography in prevention and screening of premalignant and malignant endometrial disease." Srpski arhiv za celokupno lekarstvo 134, no. 11-12 (2006): 516–20. http://dx.doi.org/10.2298/sarh0612516z.
Full textAbstract:
Introduction: The study emphasizes the significance of hydrosonography in prevention and early diagnostics of endometrial pathology. Objective: To express the significance of hydrosonography in relation to timely detection and treatment of premalignant and malignant endometrial disease. Method: Our study included 104 patients referred to transvaginal sonography, after which hydrosonography was recommended in order to obtain precise visualization of the endometrium because of suspected endometrial pathology. After hydrosonography, dilatation and curettage with endometrial biopsy were performed in all patients. Biopsy specimens were histologically analyzed. Results: The application of contrast sonography described in our research helped diagnose and timely treat as many as 30.8% of patients suffering from premalignant and malignant endometrial disease (23.2% of premalignant and 7.6% of malignant). Discomforts (bleeding and pelvic pain) occurred in 72.1% of patients, out of whom 43.3% had already undergone curettage once or more than once because of the same or similar symptoms, while 27.9% of cases presented for regular control, i.e. they were symptom free. The obtained Results clearly emphasized the significance of application of contrast sonohysterography as a Method for timely detection of endometrial pathology and its adequate treatment. Conclusion: The study shows that application of contrast sonohysterography before exploratory curettage significantly facilitates the use of invasive diagnostics and improves accuracy and validity of the obtained Results, especially in cases of endometrial focal changes; consequently, it is also possible to achieve positive cost - benefit effect.
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Boychuk, Alla V., Tetiana V. Vereshchahina, and Iryna M. Nikitina. "ESTIMATION OF RELATIVE RISK OF DEVELOPMENT AND INFORMATIVENESS OF DIAGNOSTIC METHODS OF HYPERPROLIFERATIVE PROCESSES OF ENDOMETRIUM." Wiadomości Lekarskie 73, no. 9 (2020): 2004–9. http://dx.doi.org/10.36740/wlek202009220.
Full textAbstract:
The aim: To conduct a comparative analysis of the results of ultrasound and hysteroscopic examinations with further histopathological findings and the clinical and anamnestic features of patients with hyperproliferative pathology in order to determine the etiopathogenetic mechanisms of the development of endometrial pathological processes. Materials and methods: We studied 119 medical records of patients of the Gynecological Department of Minipal Non-Commercial Enterprise “Ternopil Municipal City Hospital No. 2”, who applied for medical assistance because of benign endometrial hyperplasia in the reproductive age with a verified diagnosis of “uterine polyp” during 2017–2018. The control group consisted of 30 patients of the same age group, with menstrual disorders with no signs of hyperplastic processes of endometrium. With the consent of the patients, they were treated with diagnostic hysteroscopy in order to study evacuated material from the uterus. The results of the histological study confirmed the absence of signs of hyperplastic processes of endometrium. The results of diagnostic methods were evaluated by comparing the material’s histological data with the results of ultrasound and hysteroresectoscopy. Results: Taking into account the results of our research, women with hyperplastic processes of endometrium have the risk of the pathology of the nervous system is in 2.71 times higher (OR=2.71, CI–0.88: 8.33), cardiovascular pathology—in 2.04 (OR=2.04, CI–0.57:7.34), vascular diseases of the lower extremities—in 1.81 times (OR=1.81, CI–0.21:15.32) compared with the control group. While the risk of pathology of the urinary system and organs of vision is only—OR=0.48, CI–0.11:2.03 and OR=0.75, CI–0.08:7.48, respectively. Analyzing the results of the study using ultrasound examination, it was found that endometrial polyposis in combination with uterine leiomyoma was not detected in 3 women (15%), while all the results of hysteroscopy were confirmed by histopathological studies. When the endometrial hyperplastic processes were combined with adenomyosis— according to ultrasound examination a false positive result was obtained in 2 patients (13.3%), and in a hysteroscopic study we determined –1 false positive result. In patients the diagnosis of “endometrial polyp” according to the results of hysteroscopy was not confirmed in 2 women (2 false positive results 2.99%) and in 5 cases of ultrasound examination (5 false negative results 7.46%). The use of ultrasound examinations in patients with endometrial hyperplastic changes, according to our data, made it possible to identify pathology in 88.39% of cases, while the information content of the hysteroscopy was 98.21% (p<0.001). Conclusions: Thus, the results of the subjective examination of patients in the gynecological department: complaints, anamnestic data on gynecological and extragenital pathology should be used to identify etiopathogenetic factors and the formation of risk groups for the occurrence of hyperplastic processes of endometrium. Women with cervical erosion, uterine myoma and episodes of herpetic rash on the mucous membranes in past medical history have a higher likelihood of hyperplastic processes of endometrium. The vast majority of patients (63.87%) with polyps of the body of the uterus have a combined hyperproliferative pathology, which requires an individual approach to planning the scope of diagnostic examination and the choice of treatment method. Visualization of endometrium with hysteroscopy is more informative than ultrasound for diagnosing hyperproliferative processes, including uterine polyps. Hysteroscopic polypectomy has a high level of both clinical and economic benefits as well as diagnostic value in patients with hyperplastic processes of endometrium.
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Bhatta, S., and AK Sinha. "Histopathological study of endometrium in abnormal uterine bleeding." Journal of Pathology of Nepal 2, no. 4 (September 25, 2012): 297–300. http://dx.doi.org/10.3126/jpn.v2i4.6882.
Full textAbstract:
Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features.Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied.Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%).Conclusion: Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.Journal of Pathology of Nepal (2012) Vol. 2, 297-300DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882
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Tikhomirov, A. L., S. I. Sarsania, K. S. Tuskayev, and T. A. Yudina. "Prevention of recurrent endometrial pathology." Medical Council, no. 7 (April 5, 2019): 21–26. http://dx.doi.org/10.21518/2079-701x-2019-7-21-26.
Full textAbstract:
Therapy resistance of endometrial pathology is one of the significant issues for gynaecologists facing this problem. The features of chronic endometritis include high prevalence of infertility and recurrent endomentrial process, due to adhesive process in the uterus. This task requires an integrated approach, including the use of modern anti-adhesive barrier containing hyaluronic acid and carboxymethylcellulose.
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Ivanova, N., M. Shamarakova, and O. Panina. "Endometrial pathology in postmenopausal women." Врач 31, no. 9 (2020): 83–87. http://dx.doi.org/10.29296/25877305-2020-09-16.
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Prat, Jaime, Alberto Gallardo, Miriam Cuatrecasas, and Lluis Catasús. "Endometrial carcinoma: pathology and genetics." Pathology 39, no. 1 (February 2007): 72–87. http://dx.doi.org/10.1080/00313020601136153.
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Matias-Guiu, Xavier, and Jaime Prat. "Molecular pathology of endometrial carcinoma." Histopathology 62, no. 1 (December 13, 2012): 111–23. http://dx.doi.org/10.1111/his.12053.
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Clark, T. Justin, and Janesh K. Gupta. "Endometrial sampling of gynaecological pathology." Obstetrician & Gynaecologist 4, no. 3 (July 2002): 169–74. http://dx.doi.org/10.1576/toag.2002.4.3.169.
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Simon, Rochelle A., M. Ruhul Quddus, W. Dwayne Lawrence, and C. James Sung. "Pathology of Endometrial Ablation Failures." International Journal of Gynecological Pathology 34, no. 3 (May 2015): 245–52. http://dx.doi.org/10.1097/pgp.0000000000000147.
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Appelman, Z., A. Ben-arie, Z. Katz, C. Benjamin, and H. Zion. "Endometrial pathology in hypertensive women." Ultrasound in Obstetrics and Gynecology 11, no. 5 (May 1, 1998): 378–79. http://dx.doi.org/10.1046/j.1469-0705.1998.11050378.x.
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Lugo, Carlos, and Nazira Monsalve. "Evaluación endometrial vía histeroscopia en pacientes con cáncer de mama – receptores hormonales positivos, tratadas con hormonoterapia." Revista de Obstetricia y Ginecología de Venezuela 80, no. 04 (December 7, 2020): 312–21. http://dx.doi.org/10.51288/00800408.
Full textAbstract:
Objective: To know via hysteroscopy the endometrial pathology associated with the use of hormone therapy in patients with breast cancer. Methods: Research design: non-experimental, longitudinal, trend; based on patients who come randomly, from January to July 2014, to the consultation of Los Andes University Hospital. Results: The mean age of the patients was 55.3 years, mean time of menopause 8.03 years; 8 (26.6%) patients had associated chronic arterial hypertension and diabetes mellitus II, and 10% of the patients had arterial hypertension. The most common endometrial alterations were: 46.7 % endometrial polyps, 13.3 % simple hyperplasia without atypia, 6.6 % leiomyomas. Among 5 (16.6%) users of exemestane (all with normal ultrasound), 3 (10%) had endometrial polyps and 2 (6.7%) negative biopsies. Among the 23 (76.7%) patients taking tamoxifen, 9 (30%) had thickened endometrium, 12 (40%) normal ultrasound and 2 (6.7%) other findings; 10 (33.3 %) had polyps (6 with normal ultrasound and 4 with endometrial thickening) and 3 endometrial hyperplasia (all with thickened endometrium). Two patients receiving both treatments, one had hyperplasia and one had polyps (both with thickened endometrium). The population studies in 60% were luminal B breast cancer; 1 (3.3 %) patient had a vagal reflex as a complication of the procedure. Conclusion: Histeroscopic findings most often diagnosed were endometrial polyps, simple hyperplasia without atypia and submucosal myomas. Keywords: Hysteroscopy, endometrium, tamoxifen, cancer, breast.