Abnormal uterine bleeding: Histopathological patterns of endometrium in elderly

• Author Details:   
• Supriya Sandeepa
• Jayaprakash HT
• Ashwini MC

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 Objective

1.        To evaluate endometrial histopathological patterns in elderly women(adults > 40 years of age) with abnormal uterine bleeding.

2.        To observe the frequency of various patterns.

Methods: This is a retrospective study with evaluation of the histopathology slides of endometrial samples of 162 patients of > 40 years of age with clinical diagnosis of abnormal uterine bleeding, between 2006 to 2012 were studied.
Results: A total of 162 patients were evaluated during the study period. 85 (52.46%) cases were functional lesions, 74 (45.6%) cases showed organic pathology and 3(1.85%) were reported unsatisfactory sample for evaluation. Maximum number of cases were observed in age group of 41-50 years with proliferative phase (60 cases, 49.18%) being the most common functional lesion and endometrial hyperplasia (37 cases, 30.32%) the most common organic lesion 5 cases (3.14%) of endometrial carcinoma were observed. Other endometrial patterns were secretory phase 20(12.57%), proliferative phase 62(38.99%), disordered proliferative endometrium 1(0.62%), lytic phase 1 (0.62%), irregular shedding 1 (0.62%), chronic endometritis 3 (1.88%), pregnancy related 1 (0.62%), atrophic endometrium 6 (3.77%).
Conclusion: Endometrial hyperplasia which is a precursor of endometrial carcinoma is most common organic lesion in elderly women. Histopathological examination should be done generously in women presenting with AUB especially after the age of 40 years to rule out malignant pathology as accurate analysis of endometrial samplings is the key to effective therapy and optimal outcome.

Keywords: Abnormal uterine bleeding (AUB), Endometrium