Pathological spectrum of endometrial biopsies in Saudi women with abnormal uterine bleeding: A retrospective study of 13-years

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Figure 1
- Age group distribution of the study population.
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Figure 2
- Types of endometrial sample in the study population.
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Figure 3
- Types and percentages of the pathological endometrial samples reported in the study population. DPE: disordered proliferative endometrium, SH - simple hyperplasia, CH - complex hyperplasia
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Figure 4
- Histogram of the age stratified distribution of the hyperplasias and malignancies in the study group.

Table 1

- Age stratified histopathological spectrum of endometrial samples.

Endometrial sample reports	<40 years (n=690)	40-55 years (n=4466)	> 55 years (n=1302)	Total (N=6458)
Unsatisfactory	91 (13.2)	625 (14.0)	186 (14.3)	902 (14.0)
Proliferative phase	99 (14.4)	685 (15.3)	56 (4.3)	840 (13.0)
Secretory phase	180 (26.1)	760 (17.0)	28 (2.2)	968 (15.0)
Menstrual endometrium	3 (0.4)	33 (0.7)	4 (0.3)	40 (0.6)
Atrophic	3 (0.4)	322 (7.2)	387 (29.8)	712 (11.0)
Luteal phase defect	17 (2.5)	25 (0.6)	3 (0.2)	45 (0.7)
Effects of exogenous hormone therapy	17 (2.5)	144 (3.2)	30 (2.3)	191 (3.0)
Disordered proliferative endometrium	60 (8.7)	674 (15.1)	77 (5.9)	811 (12.6)
Chronic endometritis	39 (5.7)	242 (5.4)	28 (2.2)	309 (4.8)
Endometrial polyp	153 (22.2)	739 (16.6)	285 (21.9)	1177 (18.3)
Simple hyperplasia without atypia	18 (2.6)	152 (3.4)	84 (6.5)	254 (3.9)
Simple hyperplasia with atypia	2 (0.3)	10 (0.2)	8 (0.6)	20 (0.3)
Complex hyperplasia without atypia	5 (0.7)	6 (0.1)	13 (1.0)	24 (0.4)
Complex hyperplasia with atypia	1 (0.1)	20 (0.5)	22 (1.7)	43 (0.7)
Malignancy	2 (0.3)	29 (0.7)	91 (7.0)	122 (1.9)
TOTAL	690 (100)	4466 (100)	1302 (100)	6458 (100)

Table 2

- Tabulation of the malignant endometrial reports and the follow up hysterectomies.

Malignant endometrial samples	n (%) (n=122)	Age/age range of patients (years)	Follow up hysterectomy (n=90) n (%)	Hysterectomy diagnosis (final diagnosis)	No follow up hysterectomy (n=32) n (%)
Endometrioid adenocarcinoma	86 (70.5)	37-80	68	56 cases were same as endometrial sample report. The others:	18
	FIGO 1 = 46			6 FIGO 1 were upgraded to FIGO 2.
	FIGO 2 = 26			1 FIGO 2 was upgraded to FIGO 3.
	FIGO 3 = 14			1 FIGO 2 was changed to serous carcinoma.
				1 FIGO 3 was changed to clear cell carcinoma.
				1 FIGO 2 was changed to MMMT.
				1 FIGO 1 was changed to endocervical adenocarcinoma involving the uterine corpus.
				1 FIGO 2 was changed to metastatic colon adenocarcinoma.
Serous carcinoma	18 (14.8)	59-81	10	8 cases were same as endometrial sample report;	8
				2 cases reported as endometrioid adenocarcinoma, FIGO 3
Clear cell carcinoma	1 (0.8)	60	1	Same as endometrial sample report	0
Mixed endometrioid & serous carcinoma	1 (0.8)	67	1	Same as endometrial sample report	0
Undifferentiated adenocarcinoma	1 (0.8)	57	1	Turned out to be ovarian serous adenocarcinoma metastatic to uterine corpus	0
Malignant mixed Mullerian tumor	11 (9.0)	47 - 70	7	Same as endometrial sample report	4
Adenosarcoma	1 (0.8)	64	1	Same as endometrial sample report	0
Squamous cell carcinoma	3 (2.5)	31 - 67	1	Same as endometrial sample report	2