Journals / İstanbul Üniversitesi İstanbul Tıp Fakültesi Mecmuası / 2004 / Cilt: 67 - Sayı: 4
The histopathologic correlation of dilatation & curettage and hysterectomy specimens in patients with postmenopausal bleeding
- Pages
- 218–223
- DOI
- —
Abstract
The aim of this study was to evaluate the consistency of preoperative and postoperative histopathological findings in postmenopausal patients with bleeding. 42 postmenopausal women presenting with the complaint of bleeding to whom both dilatation&curettage (D&C) and hysterectomy were performed were examined retrospectively regarding their pathology results.Each patient's D&C and hysterectomy pathology result were compared and the consistency of preoperative and postoperative findings were evaluated by the correlation analyses. Histopathologic evaluation of specimens were performed by the pathologists specialized on gyneacologic pathology and endometrial hyperplasias were described by terms endorsed by the International Society of Gynecological Pathologists. Pathology examination of D&C and hysterectomy specimens of 42 menopausal patients were studied and the consistency of preoperative and postoperative findings were examined. The distribution of preoperative diagnosis was 16 pa¬tients (38%) with irregular proliferative endometrium, 14 patients (33%) with simple hyper-plasia, 4 patients (9.5%) with complex hyperplasia without atypia, 3 patients (7.14%) with complex hyperplasia with atypia and 3 patients (7.14%) with endometrial polyp. In one patient (2.38%), it was reported that there was no material in D&C and in one patient (2.38%) endometrium cancer was found preoperatively. The distribution of postoperative diagnosis was 16 patients (38%) with irregular proliferative endometrium, 12 patients (2.8.5%) with simple hy¬perplasia, 5 patients (11.9%) with complex hyperplasia without atypia, 4 patients (9.5%) with complex hyperplasia with atypia, 3 patients (7.14%) with endometrium cancer and 2 patients (4.76%) with endometrial polyp. The correlation analysis of these variables has shown that there was a positive correlation between variables (correlation coefficient: 0.98). This means that the preoperative diagnosis correlates positively with the postoperative diagnosis. However, when preoperative diagnosis group was subgrouped and reanalysed, it seems that while the preoperative diagnosis gets worse, D&C may skip the real and much worse pathology. Generally preoperative D&C endometrial pathology findings positively correlate with post operative hysterectomy pathology results. However, as the real pathology gets worse, D&C seems to un-derdiagnose the real pathology and in cases with complex hyperplasia with or without atypia, a second D&C or hysterescopic evaluation in order to get biopsies from suspicious areas may be recommended.
Özet
The aim of this study was to evaluate the consistency of preoperative and postoperative histopathological findings in postmenopausal patients with bleeding. 42 postmenopausal women presenting with the complaint of bleeding to whom both dilatation&curettage (D&C) and hysterectomy were performed were examined retrospectively regarding their pathology results.Each patient's D&C and hysterectomy pathology result were compared and the consistency of preoperative and postoperative findings were evaluated by the correlation analyses. Histopathologic evaluation of specimens were performed by the pathologists specialized on gyneacologic pathology and endometrial hyperplasias were described by terms endorsed by the International Society of Gynecological Pathologists. Pathology examination of D&C and hysterectomy specimens of 42 menopausal patients were studied and the consistency of preoperative and postoperative findings were examined. The distribution of preoperative diagnosis was 16 pa¬tients (38%) with irregular proliferative endometrium, 14 patients (33%) with simple hyper-plasia, 4 patients (9.5%) with complex hyperplasia without atypia, 3 patients (7.14%) with complex hyperplasia with atypia and 3 patients (7.14%) with endometrial polyp. In one patient (2.38%), it was reported that there was no material in D&C and in one patient (2.38%) endometrium cancer was found preoperatively. The distribution of postoperative diagnosis was 16 patients (38%) with irregular proliferative endometrium, 12 patients (2.8.5%) with simple hy¬perplasia, 5 patients (11.9%) with complex hyperplasia without atypia, 4 patients (9.5%) with complex hyperplasia with atypia, 3 patients (7.14%) with endometrium cancer and 2 patients (4.76%) with endometrial polyp. The correlation analysis of these variables has shown that there was a positive correlation between variables (correlation coefficient: 0.98). This means that the preoperative diagnosis correlates positively with the postoperative diagnosis. However, when preoperative diagnosis group was subgrouped and reanalysed, it seems that while the preoperative diagnosis gets worse, D&C may skip the real and much worse pathology. Generally preoperative D&C endometrial pathology findings positively correlate with post operative hysterectomy pathology results. However, as the real pathology gets worse, D&C seems to un-derdiagnose the real pathology and in cases with complex hyperplasia with or without atypia, a second D&C or hysterescopic evaluation in order to get biopsies from suspicious areas may be recommended.