Association of Endometrial Thickness with Histopathological Pattern of Endometrium with Postmenopausal Bleeding

Krishnamoorthy, Parvathavarthini; Balakrishnan, Nandhini; Prasad, Geetha

doi:10.5005/jp-journals-10032-1151

Cited by 2 publications

(5 citation statements)

References 15 publications

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“…Patients presented with age ranging from 44 to 72 years with maximum of 31.25% in age group of 46-50 years. This is similar to study by Parvathavarthini Krishnamoorthy et al, 7 Kothapally et al 10 Of these patients 57.5% were multiparous (parity >2), this is in accordance with study by Kothapally et al, Parvathavarthini Krishnamoorthy et al, Jyothsna Sravanthi et al 3 Regarding presentation of symptoms after menopause, maximum patients (53.75%) presented with PMB within 1 -5 years of menopause and 15% in 6-10 years.…”

Section: Discussionsupporting

confidence: 89%

“…23.75% had Endometrial hyperplasia which is in accordance with study by Pushpa Singh et al which showed 23.3%. 11 Adenocarcinoma was seen in 11.25% similar to findings in study by Pushpa et al which showed 13% 11 and 10% in study by Parvathavarthini et al and Kothapally et al 7,10 In our study 9 patients had Endometrial carcinoma, their age group ranged from 49 to 67 years. 1 patient was nulliparous and other 8 patients were multiparous (parity>2).…”

Section: Discussionsupporting

confidence: 88%

“…ET ranged from 6mm to 33mm with mean of 15 mm which was similar to study by Parvathavarthini Krishnamoorthy et al 7…”

Section: Discussionsupporting

confidence: 88%

“…In this study 28.75% had HT and DM compared to 20% HT and 11% DM in study by Jyothsna Sravanthi et al, 3 36% HT and 13% DM in study by Radha Nair et al 2 Transvaginal sonography showed ET>4mm in majority of cases (86.25%) similar to findings in study by Kothapally et al, 10 Radha Nair et al, 2 Parvathavarthini Krishnamoorthy et al 7 According to ACOG committee opinion no: 734, ET <4mm has a 99% negative predictive value for EM Ca. 9 Sonographic measurement of ET has to be done first in PMB to decide whether further investigations are needed to rule out malignancy.…”

Section: Discussionsupporting

confidence: 83%

“…5 Early diagnosis of EM Ca increases the 5-year survival rate up to 95%. 7 Evaluation of endometrium includes various modalities such as TVS, Hysteroscopy and guided biopsy, Dilatation and curettage, CT, MRI. But histopathology is the gold standard for definitive diagnosis.…”

Section: Etiology Of Postmenopausal Bleedingmentioning

confidence: 99%

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Clinicopathological evaluation of patients with postmenopausal bleeding in a tertiary care center

Hemalatha¹,

Thenmozhi²,

S.³

2023

IJOGR

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Postmenopausal bleeding (PMB) is frequent finding in 5-10% of women in gynaecology clinic. About 10% of these patients have primary or secondary malignancy. PMB requires complete assessment to ensure the absence of malignancy and to identify and treat high risk patients such as those with endometrial hyperplasia.The aim of this study is to investigate the clinical significance and endometrial pathology in patients with PMB.A retrospective study on postmenopausal women visiting a tertiary care center between 2016 January to 2017 December was taken up for study. About 80 patients with PMB were selected and these patients were evaluated by pelvic USG, Endometrial biopsy and Endometrial histopathology.Maximum patients with PMB belonged to age group of 46-50 years (31.25%). 57.5% were multiparous (parity>2). About 53.75% had PMB 1 to 5 years after menopause. Endometrial thickness (ET) was > 4mm in 86.25%. Majority had ET between 5-10mm (58.75%). Histopathological analysis of endometrial curettings showed Proliferative phase in 35%, disordered proliferative phase in 17.5%, Atrophic Endometrium in 13.75% and endometrial carcinoma in 11.25%.Postmenopausal bleeding is an important symptom which requires evaluation to eliminate possibility of malignancy. Transvaginal sonography (TVS) is the first mode of investigation for PMB but Histopathology of Endometrium serves as gold standard for definitive diagnosis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 88%

“…ET ranged from 6mm to 33mm with mean of 15 mm which was similar to study by Parvathavarthini Krishnamoorthy et al 7…”

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 83%

Section: Etiology Of Postmenopausal Bleedingmentioning

confidence: 99%

See 3 more Smart Citations

Clinicopathological evaluation of patients with postmenopausal bleeding in a tertiary care center

Hemalatha¹,

Thenmozhi²,

S.³

2023

IJOGR

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A prospective study of endometrial histopathology in post-menopausal women in Jharkhand

Kumari,

Paswan,

Kundan

et al. 2024

Journal of Family Medicine and Primary Care

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Introduction: Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal women. In the early menopausal years, endometrial hyperplasia, polyps and submucosal fibroids are common etiologies of post menopausal bleeding. The most common cause of postmenopausal bleeding is endometrial atrophy, comprises of 60-80%, while endometrial hyperplasia and endometrial cancer contribute to only 11% of Post menopausal bleeding. The aim of study is to analyses histomorphological pattern of endometrium in patients presenting with post-menopausal bleeding in Jharkhand. Materials and Methods: 103 postmenopausal women presenting to tertiary center of Jharkhand in 2020-22 with bleeding were subjected to endometrial curettage for histopathology. Analysis is based on morphological criteria to assess endometrium. Endometrial histology is of four categories: Proliferative, Secretory, premalignant and carcinoma. Results: The highest incidence of postmenopausal bleeding was noticed in age group of < 60 years and incidence of malignancy was higher after 57 years of age. The majority of patients had parity between 1 and 3 (78.6%). Malignant & premalignant lesions comprises about 22.3% among that 77.7% were due to benign causes. Among the benign causes of postmenopausal bleeding, proliferative endometrium was the commonest finding. Types of hyperplasia encountered were simple hyperplasia without atypia (6.8%), Complex hyperplasia without atypia (3.9%),Complex hyperplasia with atypia (4.8%) and Simple hyperplasia with atypia (4.8%). 21.4% of cases of postmenopausal bleeding were associated with atrophic endometrium. Secretory endometrium seen in 17.5% of women. Endometrial carcinoma accounted for 12.6% of cases of postmenopausal bleeding. Out of these 69.2% were of endometroid type of endometrial carcinoma, 15.3% were of papillary serous carcinoma and 15.3% had clear cell carcinoma. The mean age of patients with endometrium carcinoma was 62.3 years. All cases of endometrial carcinoma were associated with 1 or more risk factor like diabetes/hypertension/Nulligravida. Conclusion: Proliferative Endometrium was a major cause of postmenopausal bleeding. Among the malignant causes, endometrial adenocarcinoma of endometroid type was most frequent with a lower mean age at presentation than other high grade cancers like papillary serous carcinoma & clear cell carcinoma.

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Association of Endometrial Thickness with Histopathological Pattern of Endometrium with Postmenopausal Bleeding

Cited by 2 publications

References 15 publications

Clinicopathological evaluation of patients with postmenopausal bleeding in a tertiary care center

Clinicopathological evaluation of patients with postmenopausal bleeding in a tertiary care center

A prospective study of endometrial histopathology in post-menopausal women in Jharkhand

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