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Table of Content - Volume 21 Issue 2 - February 2022


Histopathological spectrum of uterine lesions in perimenopausal and postmenopausal women: A retrospective study


Sarita Pathak1, Sunita Rai2*


1Postgraduate, 2Assistant Professor, Department of Pathology, Gajraraja Medical College (GRMC) Gwalior, INDIA.

Email: savarnita22@gmail.com


Abstract              Background: This study was done to investigate various endometrial causes of abnormal uterine bleeding that comes to our hospital and its incidence mainly in the perimenopausal and postmenopausal females. Methodology: There were 166 cases submitted for HPE of uterine lesions including 140 cases of hysterectomy specimen,18 cases of endometrial biopsy,8 cases of cervical biopsy in a age of 41-80 years female patients. Results: In present study histological examination revealed 11% cases of Adenomyosis which is the most common lesion of uterus in our study, that too in perimenopausal women, cases of Brenner tumour and mucinous cystadenocarcinoma of ovary found to be rare cases forming 2% in postmenopausal women, rest of the cases fall in between including benign and malignant cases. Conclusion: Benign and Malignant lesions of uterus are found to be common in both age group of patients that is (41-50 years) and (50 years and above) but malignant conditions are more prevalent in postmenopausal females as in our study.                          

Keywords: Uterine Lesions, Perimenopausal, Postmenopausal.



Perimenopausal and post menopausal women have various uterine lesions due to hormonal changes, immunological and inflammatory response.1 This is due to inflammatory response to mainly bacteria, candida, trichomoniasis and due to low socioeconomic status and ignorant behavior toward general hygiene.1                         



This is a retrospective study of women presenting with abnormal uterine bleeding and abdominal mass, in Histopathology section Department of Pathology at GRMC Gwalior over a period of one year i.e. May 2020 to June 2021. All hysterectomy specimens including endometrial and cervical biopsy were also taken in to this study. The specimen are processed, stained and subjected to microscopic examination to arrive at histopathological diagnosis. Out of 166 cases of uterine lesions which included 140 cases of hysterectomy specimen, 18 cases of endometrial biopsy and 8 cases of cervical biopsy in age ranged from 41 to 80 years including perimenopausal (41-49 years) and postmenopausal (50 years and above).



In present study, the most common finding in endometrial lesion is adenomyosis and leiomyoma that is 11% and 9.30% cases respectively in perimenopausal and 12% and 7.50% respectively in postmenopausal females. We have concluded rest of the cases by graphical representation as below.                            

Figure 1: Uterine lesions (Perimenopausal females 41 to 49 years)


Figure 2: Uterine lesions (Postmenopausal women (50 years ans above))


Images related to common uterine lesion in present study.

Figure 3: leiomyoma(10x)             Figure 4: Adenomyosis(40x)


Figure 5: Endometrial hyperplasia without atpia(40x); Figure 6: Endometriod adenocarcinoma(40x)





Abnormal uterine bleeding is a major gynaecological problem, accounting for 33% of outpatient referrals, including 69% of referrals2 in peri-menopausal and postmenopausal age group. One third of patients attending gynaecology OPD present with complaints of abnormal uterine bleeding.3 The menstrual disorders increases with age and in our study the most common finding in uterine lesions are adenomyosis (11%) and leiomyoma (9.30%) mainly in the perimenopausal women this was consistent with the findings of Smriti S. Dwivedi et al.4 and Dalia M badary et al.5 Chronic Endometritis was reported in 1.40% of cases in perimenopausal group which was comparable with study conducted by Sudhamani et al.6 who reported in 2.43%. In our study 1.40% of cases in perimenopausal group showed tuberculous endometritis comparable to study conducted by Rajshri et al.7 reported in 1.1% of cases. Endometrial hyperplasia is more common that is 5.50% cases in perimenopausal as compared to postmenopausal females These findings were similar to the findings described in a research done by Sujata j et al. 10.9%.8 In present study atrophic endometrium is very common, while 2.80%cases of endometrial carcinoma is also seen. Similarily M. B. Swami et al.9 observed 5.0%cases and Kavita et al.10 noticed 6.2% cases of endometrial carcinoma respectively. Stromal tumour were observed in 1.50%cases which was comparable with M. B. Swami et al.9 1.7%cases. In adnexal lesions, surface epithelial tumour of the ovary are the most common finding in present study.                                                                                                                     



There is an age specific association of uterine lesions so histopathological examination will pin point the exact cause of abnormal uterine bleeding and abdominal masses and will help in proper management at its earliest by proper diagnosis.



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