Journal Info

Title: Jurnal Medical Aradean (Arad Medical Journal)
Abbreviated title: J. Med. Ar.
Publisher: "Vasile Goldis" University Press
Owner: Western University "Vasile Goldis" Arad, Romania
ISSN: 1224-3744
e-ISSN: 2067-7790

Ranking and Indexing

Rank: CNCSIS C (code 292) since 2010

International Database: Index Copernicus Journal Master List Value (2010): 4.66

Who's Online

We have 23 guests online

Index Databases

Written by Ulgut C.,Paiusan L.,Furau G.   
Read full article
Authors: Corina Ülgüt, Lucian Paiusan, Gheorghe Furau, Casiana Stanescu
Affiliation: ¹As.Univ.Drd., Resident Doctor, Pathology Departament, County Emergency Hospital Arad
“Vasile Goldis” Western University Arad, Faculty of Medicine, Morphopathology Department
² Conf.Univ., Head of Departament, Pathology Departament, County Emergency Hospital Arad
“Vasile Goldis” Western University Arad, Faculty of Medicine, Morphopathology Department
³Conf.Univ., Head of Departament, Obstetric and Gynecology Departament, County Emergency Hospital Arad
“Vasile Goldis” Western University Arad, Faculty of Medicine
Abstract: Abnormal uterine bleeding is a common gynaecological complaint, an important problem of menopause women’s health. Post menopausal bleeding is generally regarded as an ominous and serious alarm of genital pathologies. The term "post menopausal bleeding" generally implies bleeding from the uterus and it is essentially the only bleeding of importance at the postmenopausal age. The current study was carried out to evaluate various causes of postmenopausal bleeding based on histopathology, and the percentage of various benign, premalignant and malignant endometrial and cervical lesions in post menopausal bleeding.This retrospective study of endometrial pathology in postmenopausal bleeding was conducted by the Pathology Departament of the Obstetric and Gynecology Hospital of Arad, Romania, between January 2010 – December 2014. We examined a number of 258 postmenopausal women that came with abnormal uterine bleeding. Exclusion criteria were premature menopause whether surgical or natural, age less than 55 years and patients on hormone replacement therapy. In our study atrophy of the endometrium and chronic hypotrophic endometritis was the predominant finding in the women in the postmenopausal period (41,85%). The incidence of benign endometrial polyps (12,02%), adenocarcinoma of the endometrium was found in 27,52% of the samples. Endometrial hyperplasia, with or without atypia, is considered to be a precursor of carcinoma [13] and was found in about 15,50% of women in the present study. Postmenopausal bleeding is a symptom of varied etiologies and is not always because of malignant conditions. Therefore, the histologic examination has to be careful in order to find benign, premalignant and malignant lesions. An accurate diagnosis will make it much easier to counsel the patient confidently about the appropriate course of action and facilitate in carrying out the proper treatment plan that will benefit the patient.
Keywords: endometrial atrophy, benign endometrial polyps, endometrioid carcinoma
References: 1. Hawwa ZM, Nahhas WA, Copenhaver EH. Postmenopausal bleeding. Lahey Clinic Foundation Bulletin, 1970, 19:61–70.
2. Astrup K, Olivarius NDeF. Frequency of spontaneously occurring postmenopausal bleeding in the general population. Acta Obstetricia et Gynecologica Scandinavica, 2004, 83(2):203–7.
3. Pacheco JC, Kempers RD. Etiology of postmenopausal bleeding. Obstetrics and Gynecology, 1968, 32:40–46.
4. Lidor A et al. Histopathological findings in 226 women with postmenopausal bleeding. Acta Obstetricia et Gynecologica Scandinavica, 1986, 65:41–43.
5. Parazzini F et al. The epidemiology of endometrial cancer. Gynecologic Oncology, 1991, 41:1–16.
6. Norris HJ, Tavassoli FA, Kurman RJ. Endometrial hyperplasia and carcinoma. Diagnostic considerations. American Journal of Surgical Pathology, 1983, 7(8):839–847.
7. Alberico S et al. A clinical and epidemiological study of 245 postmenopausal metrorrhagia patients. Clinical and Experimental Obstetrics and Gynecology, 1989, 16:113–121.
8. Gordon MD, Ireland K. Pathology of hyperplasia and carcinoma of the endometrium. Seminars in Oncology, 1994, 21(1):64–70.
9. Hunter JE et al. The prognostic and therapeutic implications of cytologic atypia in patients with endometrial hyperplasia. Gynecologic Oncology, 1994, 55:66–71.
10. Escoffery CT, Blake GO, Sargeant LA. Histopathological findings in women with postmenopausal bleeding in Jamaica. West Indian Medical Journal, 2002, 51(4):232–235.
11. Goff BA et al. Uterine papillary serous carcinoma: patterns of metastatic spread. Gynecologic Oncology, 1994, 54:264–268.
12. Al-Kadri HM, Al-Awami SH, Madkhali AM. Assessment of risk factors of uterine cancer in Saudi patients with postmenopausal bleeding. Saudi Medical Journal, 2004, 25(7):857–861.
13. Caspi E, Perpinial S, Reif A. Incidence of malignancy in Jewish women with postmenopausal bleeding. Israel Journal of Medical Sciences, 1977, 13(3):299–304.
14. Fortier KJ. Postmenopausal bleeding and the endometrium. Clinical Obstetrics and Gynecology, 1986, 29:44–45.
15. Gredmark T, Havel G, Mattsson L-A. Histopathological findings in women with postmenopausal bleeding. British Journal of Obstetrics and Gynaecology, 1995, 102(2):133–136.
16. Kuwashima Y et al. Intramural carcinomas of the uterine corpus: a clinicopathological study. In Vivo, 1997, 11(3):253–260.
17. Ross JC et al. Primary mucinous adenocarcinoma. Seminars in Oncology, 1994, 21:64–70.
18. Sherman ME et al. Uterine serous carcinoma. A morphologically diverse neoplasm with unifying clinicopathologic features. American Journal of Surgical Pathology, 1992, 16:600–610.
19. Hendrickson MR, Ross JC, Kempson RL. Towards the development of morphologic criteria for well differentiated adenocarcinoma of the endometrium. American Journal of Surgical Pathology, 1983, 7:819–838.
20. Abeler VM, Kjorstad KE. Endometrial squamous cell carcinoma: report of three cases and review of the literature. Gynecologic Oncology, 1990, 36:321–326.
21. Abeler VM, Kjorstad KE. Clear cell carcinoma of the endometrium: a histopathological finding and clinical study of 97 cases. Gynecologic Oncology, 1991, 40:207–217
22. Tjarks M, Van Voorhis BJ. Treatment of endometrial polyps. Obstet Gynecol 2000; 96:886–9.
23. Hendrickson, MR. and Kempson, R.L. The uterine corpus. in Diagnostic Surgical Pathology, edited by Sternberg, S.S., 2nd ed, New York, Raven Press Ltd, 1994, p. 21 10.
24. Silverberg, SG. and Kurman, R.J. Tumors ofthe uterine corpus and gestational trophoblastic disease. Washington, DC. Armed Forces Institute of Pathology, 1991.
25. Dallenbach—l-Iellweg, G. and Poulsen, H. Atlas ofendomctrial histopathology. Second ed. Verlag, Berlin, Heidelberg, Springer, 1996, p. 4.