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Abstract
Background: Abnormal uterine bleeding (AUB) is one of the most frequent gynecological complaints and often reflects a wide spectrum of underlying endometrial pathology.
Objective: This study aimed to determine the histopathological patterns of endometrial samples obtained from women presenting with AUB in a tertiary care hospital in Pakistan.
Methods: This cross-sectional study was conducted in the Department of Pathology in collaboration with the Department of Obstetrics & Gynecology at Sir Ganga Ram Hospital, Lahore from March 2025 to June 2025. A total of 145 women aged 20–75 years presenting with AUB and undergoing dilatation and curettage were included using non-probability consecutive sampling. Endometrial tissues were processed, stained with H&E, and examined by a consultant histopathologist. Results: The mean age of participants was 45.8 ± 10.6 years. Proliferative endometrium was the most frequent finding (38.6%), followed by secretory endometrium (18.6%). Inflammatory endometrium, including acute and chronic endometritis, accounted for 12.4%, while endometrial tuberculosis was diagnosed in 2.0% of cases. Endometrial hyperplasia was seen in 15.8% of samples, with both atypical and non-atypical forms identified. Benign lesions such as polyps and leiomyomas were found in 9.6% and 4.1% of cases, respectively.
Conclusion: AUB is associated with diverse histopathological patterns ranging from normal physiological endometrium to premalignant and malignant conditions. Endometrial sampling remains an essential diagnostic tool, particularly for detecting hyperplasia and malignancy in high-risk women.