Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
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        Endometrium Biopsies
      
Endometrium Pathology

Reasons to biopsy:

  • abnormal bleeding:

    • post occult spontaneous abortion

    • chronic endometritis or endometriopathy [LMC-05-2084]

    • polyps

    • submucous leiomyomata [LMC-02-3578]...may not stop with Provera

    • dysfunctional uterine bleeding (DUB), NOS (until biopsy clarifies the basis)

    • perimenopausal hypoestrogenic weakly proliferative endometrium

    • perimenopausal disordered (menstual series has a lot of anovulatory cycles) proliferative endometrium...(when D&C has a large quantity of tissue, it is what old terminolgy had as non-adenomatous, noncomples, "simple hyperplasia" [L06-8378]).

    • hyperplasia/malignancy

    • medications (aspirin)

    • coagulation disorders

  • pelvic pain

  • uterine enlargement

  • endometrial lining thickening by U/S

  • patient on carcinogenic medications

Volume as a diagnostic Aid
Scant Intermediate Plentiful
atrophy cycling disordered proliferative
inactive endometritis hyperplasia
HRT effect HRT effect HRT effect
oral contraceptive effect early hyperplasia gestation
adenomatous "change"1, typical or atypical [LMC-02-6383] polypoid cystic atrophy [LMC-04-9410] carcinoma
post thermal- or cryo- ablation   polyp
Lupron therapy (medical menopause induction)   polypoid cystic atrophy [LMC-04-9410]

Glands:stroma ratio

<1:1 no > than 1:1 >1:1
early proliferative mid proliferative mid secretory
inactive late proliferative early secretory
atrophy...even polypoid cystic atrophy [LMC-04-9410] mid secretory hyperplasia
progestin therapy disordered proliferative gestation
>day 20 secretory   carcinoma
oral contraception effect    
post-ablation    
disordered proliferative [S-04-13194]    

References:

  1. Hendrickson & Kempson, Surgical Pathology of the Uterine Corpus, 1980.

(posted May 2002; latest addition15 November 2004)

 
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