Résumé
Background: Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Accurate analysis of endometrium & localization of intrauterine lesion is the goal to effective management & better outcome of problem. Aims & Objective: To evaluate various histopathological features in D & C and/or hysterectomy in patients presenting with abnormal uterine bleeding and to find the efficacy of D & C as a better, cost effective and minimally invasive tool for screening in patients with AUB. Materials and Methods: The present study was conducted in Department of Pathology, tertiary care hospital, Ahmedabad, Gujarat, India over a period of one and half years. A total 320 patients aged 20 years & above, presenting with AUB were included. Endometrial samples were analysed, histopathological changes identified and classified. Results: Age of patients ranged from 21 to 70 years mean age being 42.6 ± 6.9 years, maximum patients (53.4%) belonged to 41-50 years of age group. Most common histopathological pattern was normal cyclical endometrium (47.3%) followed by endometrial hyperplasia (42.9%). Endometrial hyperplasia was most common (57.1%) in perimenopausal age group (41-50 years). The diagnostic accuracy of D &C was found to be 93.4%; amongst all histopathological patterns it was maximum for complex hyperplasia (typical and atypical) and simple atypical hyperplasia. Conclusion: Endometrial causes of AUB are age related therefore it is specially recommended in women of perimenopausal age group to rule out preneoplastic and neoplastic etiology. D & C is an accurate, minimally invasive outdoor procedure for detecting endometrial pathology especially hyperplasia.
Résumé
Lupus erythematosus can have varied manifestation in skin ranging from classical lesion of DLE (Discoid Lupus Erythematosus) and photosensitivity to Necrotic lesions of vasculitis or atrophic lesion. Panniculitis as histological finding in biopsy taken from any lesion of SLE (Systemic Lupus Erythematosus) is expected as associated finding. We report one case with lipoatrophy as sole manifestation of lupus panniculitis in which patient presented to us with bilateral facial lipoatrophy. On further investigation patient was ANA (Antinuclear Antibody) positive and histopathology was also suggestive of lupus panniculitis. LE (Lupus Erythematous) presenting solely as lupus panniculitis is rare clinical manifestation and poses a considerable diagnostic challenge more so when presentation is lipoatropy.