European Journal of Molecular & Clinical Medicine

Background: Abnormal uterine bleeding (AUB) is the most common clinical presentation in premenopausal and postmenopausal period which could be due to either endometrial or cervical lesions. Early detection of precursor lesions and exclusion of malignancy is a diagnostic challenge for pathologists. Many studies were done on either endometrium or cervix alone, hence we took this study to evaluate both simultaneously before the hysterectomy. Objectives: To profile the histomorphological spectrum of endometrium and cervical lesions on curettage and biopsy concurrently before hysterectomy and correlation with hysterectomy specimens wherever available.
Materials and Methods: The present study was conducted on 153 cases of endometrial curetting’s and cervical biopsies received from Department of Gynaecology to Department of Pathology, RIMS, Raichur during a period of February 2020 to January 2022. Histopathology slides were retrieved from the archives of Department of Pathology. New slides were made from Paraffin embedded blocks wherever necessary and stained with Haematoxylin and Eosin. Histopathological examination of the hysterectomy specimens was conducted wherever available.
Results: Majority of the patients were in third decade of life with mean age of 41.3 years (P<0.0001) and the commonest clinical indication was AUB ((P<0.0001). Majority of the endometrium showed cyclical changes in both endometrial curettage and in hysterectomy specimens which showed a perfect positive coefficient correlation of 0.92 (P value = 0.028). Similarly, the cervical biopsy and cervix findings in hysterectomy specimen showed a highly significant P < 0.0001. The commonest histomorphological lesion in cervix was non-specific chronic cervicitis (NSCC).
Conclusion: Abnormal uterine bleeding is a major gynaecological problem in perimenopausal and post-menopausal women. It could be due to either endometrial / cervical lesions hence if it is evaluated simultaneously with a minimally invasive procedure as our study so that unnecessary radical surgeries can be avoided and medical/ conservative treatment could be offered.