Abstract

Abnormal uterine bleeding is one of the most common symptoms in gynecologic disorders of which dysfunctional uterine bleeding (DUB) is frequently encountered. Although the correct diagnosis of DUB relies on various assessments such as the menstrual cycle, basal body temperature, endocrine assay, vaginal cytology and endometrial histologic findings, pathologists have been encountered in many instances which have to make a diagnosis on the endometrium only. In view of great difficulties to make a proper histologic evaluation of endometrium in cases of DUB, the present study is undertaken to asses the pattern of the endometrium in DUB among Koreans. The material consisted of 123 cases of endometrial curettage specimens diagnosed as DUB, among which 17 cases were subjected to total hysterectomy. Histologic examination was carried out through routine formaline fixed-paraffin embedding methods followed by hematoxylin-eosin staining routinely and other special stainings as required. Histologic pattern of the endometrium was classified according to Handrickson and Kempson (1980) and clinical correlation was made. The following results were obtained: 1) The pattern of the endometrium in DUB was predominantly non-secretory type (77 cases) and the secretory type was observed in 46 cases. Abnormal endometrial histology was found in 73 cases of which 59 cases was non-secretory and 14 cases secretory type. 2) The incidence of anovulatory bleeding in DUB was 59%. 3) The bleeding pattern was mostly metrorrhagia but menometrorrhagia was predominant in cases of hyperplasia. 4) The incidence of recurrent bleeding was 31% and relatively higher in secretory endometrium.