Spectrum of pathologies observed in endometrial biopsies of cases with abnormal uterine bleeding – A retrospective study

Abstract

Background: Abnormal uterine bleeding (AUB) is one of the most common presenting symptoms in women of all age groups in outpatient departments. It is caused by various endometrial pathologies and histopathological evaluation of endometrial biopsy helps in identifying them. Aim: The aim of this study was to determine various histopathological patterns of the endometrium in women presenting with AUB and to estimate the incidence of various pathologies in different age groups in our study population. Materials and Methods: It was a retrospective study of endometrial biopsies done for AUB, received at Metropolis Healthcare Limited, from 2018 to 2023. A total of 23,155 specimens consistent with the inclusion criteria were considered for the study. Results: The most common age group presenting with AUB was 26–40 years (54.91%). The majority of the samples were obtained from patients who presented with complaints of menorrhagia. The most common normal cyclic endometrial pattern that was observed is secretory phase endometrium (22.15%). The most common abnormal endometrial pattern was endometrial polyp (17.56%). About 586 cases (2.53%) were malignant and 5965 cases (hyperplasia with and without atypia) were presented with pre-malignant status. Conclusion: In our study, the majority of cases were benign hormone-related and endometrial polyps were the most common pathology in reproductive age women, perimenopausal and the post-menopausal women, respectively. Endometrial sampling is recommended in all cases presenting with AUB, particularly in peri- and post-menopausal women due to the focal nature of atypia in polyps and hyperplasia.