HISTOPATHOLOGICAL SPECTRUM OF ENDOMETRIAL FINDINGS IN WOMEN WITH ABNORMAL UTERINE BLEEDING: A RETROSPECTIVE STUDY AT A TERTIARY CARE TEACHING HOSPITAL IN NORTHWESTERN INDIA

Abstract

Background: Abnormal uterine bleeding (AUB) is a common gynaecological presentation with causes ranging from physiological hormonal variation to premalignant and malignant endometrial disease. Histopathological examination of endometrial tissue remains central to identifying clinically important endometrial lesions. Methods: This retrospective, descriptive, single-centre study included 101 women evaluated for AUB in the Department of Pathology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab (, between 1 January 2025 and 31 December 2025. The specimens comprised 65 hysterectomy specimens and 36 endometrial curettings or biopsies. Clinical details were retrieved from medical records. Tissues were fixed in 10% neutral buffered formalin, processed routinely, sectioned at 4–5 µm, stained with haematoxylin and eosin, and examined by light microscopy. Diagnoses were assigned according to the World Health Organization classification of tumours of the female genital tract. Findings were summarised as frequencies and percentages; no inferential statistical testing was performed. Results: The largest age group was 41–50 years (43/101, 42.6%). Heavy menstrual bleeding, recorded in the source records as menorrhagia, was the most frequent presentation (69/101, 68.3%). Proliferative endometrium was the most common histological finding (36/101, 35.6%), followed by secretory endometrium (23/101, 22.8%) and disordered proliferative endometrium (15/101, 14.9%). Atrophic endometrium was seen in nine cases (8.9%). Cyclical or non-neoplastic patterns accounted for 83 cases (82.2%) and organic endometrial lesions for 18 cases (17.8%). Endometrial polyps and endometrial hyperplasia were each identified in six cases (5.9%), endometritis in three (3.0%), and endometrial carcinoma in three (3.0%). Conclusion: Most endometrial specimens from women with AUB showed benign cyclical or non-neoplastic patterns. Nevertheless, the detection of hyperplasia and carcinoma in 8.9% of the cohort supports systematic endometrial assessment, particularly in women aged 40 years or older and in those with persistent, recurrent, or postmenopausal bleeding.