Abstract
Objective
To estimate the positive predictive value of Pipelle endometrial sampling in detecting
the presence of an underlying endometrial polyp. The secondary objective is to examine
the histologic features that can predict the presence of endometrial polyps.
Study design
This is a retrospective case review study. 195 women who had undergone diagnostic
hysteroscopy and/or polypectomy were identified in a University teaching hospital.
All patients had a prior polyp diagnosis in the Pipelle endometrial sample. The histology
of these samples were compared and analyzed with subsequent DH findings and final
hysteroscopic biopsies. Slides were reviewed by 2 gynaecological pathologists.
Results
162 women were premenopausal (mean age 46.1, SD = 4.6) and 33 were postmenopausal (mean age 57.2, SD = 8.1). The commonest indication for a Pipelle endometrial sampling was abnormal uterine
bleeding. Presence of polyp was confirmed by DH in 56.3% (111/195) cases. Of these,
81.1% (90/111) were confirmed histologically. The positive predictive value of detection
of polyps in Pipelle endometrial samples for premenopausal and postmenopausal women
was 53.7% and 72.7%, respectively (p = .05). The most reliable histologic features that can predict the presence of an underlying
polyp was fibrous stroma (p = .01) and focal glandular clustering (p = .03). The prevalence of endometrial hyperplasia and carcinoma in women who was confirmed
to have polyp was 11.7% (13/111).
Conclusion
The positive predictive value of Pipelle endometrial samples in detecting endometrial
polyps was 56.3%. It was higher in the postmenopausal women (72.7%) compared to premenopausal
women (53.7%). The prevalence of endometrial hyperplasia and carcinoma in women who
was confirmed to have polyp was consistent with the rate reported in the literature.
Using ultrasonography as an adjunct maybe helpful in diagnosing endometrial polyps.
Keywords
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Article info
Publication history
Published online: April 29, 2016
Accepted:
April 23,
2016
Received in revised form:
April 5,
2016
Received:
December 28,
2015
Footnotes
☆The study was presented in part as a poster presentation at the 103rd The United States and Canadian Academy of Pathology (USCAP) Annual Meeting on March 1–7, 2014 at 111W Harbor Dr, San Diego, CA.
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
