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The Korean Journal of Pathology 1975;9(2): 145-154.
자궁내막생검 2235예와 자궁경관 생검 518예의 병리학적 소견
Pathological Findings of 2,235 Cases of Endometrial Biopsies and 518 Cases of Cervical Biopsies
ABSTRACT
Total 2753 cases of endometrial and cervical biopsies during 12 years period from Jan. 1964 to June, 1975 were examined at the Dept. of Pathology, Ewha Womans University Hospital. The total 2235 endometrial biopsies revealed 1187 cases (53%) of necrotic decidual or placental tissue, 115 cases (5%) of endometritis, 101 cases (4.5%) of endometrial hyperplasia, 24 cases(1.2%) of polyp, and 16 cases(0.8%) of malignancies. Among the 115 cases of endometritis, 92% of non-specific chronic endometritis and 8% of tuberculous endometritis were found. 101 cases of endometrial hyperplasia revealed 62 cases (62%) of cystic hyperplasia and 39 cases (38%) of adenomatous and atypical hyperplasia. 16 cases of malignancies showed 50% of choricarcinoma, 21% of adenocarcinoma, 21% of squamous cell carcinoma, and 8% of adenoacanthoma. The 518 cervical biopsies show 216 cases(41%) of chronic cervicitis, 100 cases(19%) of cervical polyp, 9 cases(1.7%) of cervical dysplasia, and 189(36%) of malignancies. The 189 cases of malignancies revealed 4.8% of Carcinoma in situ, and 31.7% of invasive cancer in which 94% of the squamous cell carcinoma, and 2%l of adenoacanthoma, were identified. Materials and Methods; The present study based on the pathological findings of the 2235 cases of endometrial biopsies and 518 cases of cervical biopsies which were performed at the OB-Cyn clinic with variable symptoms in different age groups. Most of the cases were specimens derived from the dilatation and curettage (D&C)with anesthesia. Few of them were the performances of the menstrual regulation (M-R) which was followed by the suction curettage. The average 5 gms of tissue obtained from the performances were immediately placed in 10% buffered formalin, and submitted to our histology. Biopsies were sectioned at least 3 levels and stained with H&E. Results and Summary: Histopathologic studies were made on the 2235 endometrial biopsies. Following results are obtained. 1. Most frequent age group of patients with endometrial biopsies was in between 20-40 years old with average age of 30 years. The cervical biopsies were in between 30-50 years old with average age of 40 years. 2. Most common clinical symptoms of endometrial biopsies were bleeding, amenorrhea, and sterility in order. The cervical biopsies were bleeding, leukorrhea, and backache in order. 3. The endometritis was 5% of all endometrial biopsies which were slightly higher than the report made in the United State. Tuberculous endometritis was 8% of all endometritis and was 2% of all sterility patients. 4. 4,5% of all endometrial biopsies showed endometrial hyperplasia in which cystic hype rplasia was 60%, and adenomatous and atypical hyperplasia was 38%. The average age was 39 years old which was 15 years earlier than the average of the endometrial adenocarcinoma. 5. The hydatidiform mole was 2.6% of all endometrial biopsies which was higher incidence than the report made in the United State. The average age was 26 years old which was relatively younger than other University Hospital reports. 6. 0.8% malignancies of all endometrial biopsies were diagnosed. Of these malignancies, the choriocarcinoma was one-half with average age of 54 years old, and the squamous cell carcinoma was one-fourth with average age of 54 years old. 7. Majority of 41% cervicitis among all cervical biopsies were non specific chronic cervicitis. The cervical dysplasia with average ages of 39 years old and the carcinoma in situ with average of 43 years old were 6% of all cervical biopsies. 8. The invasive carcinoma was 31.7% of all cervical biopsies. It is significant to note the large difference of incidence in between the carcinoma in situ and invasive cancer of this study in comparison with the reports made in the United State and Western Europe where the precancerous lessions were much higher than invasive cancer. The average age of invasive cancer was 4 years higher than Carcinoma in situ while the difference of years was 10 years in the western countries. 9. Among the cervical carcinoma, the squamous cell carcinoma was 94% and adenocarcinoma was 3.7%. The conclusion of the study is that all pathogists are familiar with histologic interpretation of endometrial specimens. On the contrary, meaningful interpretation of cytologic material from the endometrium requires considerable experience. therefore the confirmatory diagnosis should be made on the basis of a endometrial biopsy. Among the Korean female, the analysis of endometrial biopsies revealed greater incidence of hydatidiform mole and choriocarcinoma in comparison with greater incidence of adenocarcinoma in the United State and Europe. Tuberculous endometritis is one of the frequent causes of sterility in Korea. The lower incidence of precancerous lesion in perhaps due to the lack of understanding for routine screening of cancer among ordinary female. Therefore, understanding on routine screening of cancer should be emphasized.