What Does an Endometrial Biopsy Result Suggestive of an Endometrial Polyp Mean? [6J]

INTRODUCTION: Endometrial polyps (EMPolyp) are a common cause of abnormal uterine bleeding (AUB). For over 30 years endometrial biopsy (EMB) has been an important tool in the work up of AUB. Occasionally the pathologic sample obtained from an EMB may note a “possible” EMPolyp. However, hysteroscopy is considered the “gold standard” for diagnosis of EMPolyps. Our study attempts to look at existence of an EMPolyp when suggested by EMB. METHODS: We reviewed all EMBs send to our pathology lab during the last full year (2014). All EMBs read as “endometrial polyp” or “suggestive of endometrial polyp” were analyzed. Demographic data and medical histories were obtained on these patients. Pre-EMB ultrasounds (US) and post EMB hysteroscopy operative notes, if available, were reviewed. RESULTS: An EMB suggestive for polyps was noted in 102 of 1,380 (7.4%) procedures done for AUB. The mean age was 47.3±10.5 years and BMI 30.6±8.7 kg/m2. Diabetes was noted in 14/102 (13.7%) and hypertension in 36/102 (35.3%). In the 32 patients that underwent follow-up hysteroscopy, polyps were noted in 24. Thus EMB correctly identify the polyps in 75% of cases. Of the 23 Pre-biopsy US all but one correctly predicted the presence or absence of EMPolyp. CONCLUSION: An EMB finding suggestive of EMPolyp appears to overcall their existence. Even non-saline infusion sonography appears to be a better predicator than EMB in diagnosing the presence or absence of an EMPolyp.