Pathology Associates Of Lexington, P.A.

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:

(posted May 2002; latest addition15 November 2004)