Endometrium and Fibroid tissue

Cancer

Report in 120Hrs

At Home

No Fasting Required

Details

Histopathology of uterine lining & fibroids.

₹1,110₹1,586

30% OFF

Endometrium and Fibroid Tissue Test - Comprehensive Information Guide

Why is it done?
- This test involves microscopic examination of tissue samples obtained from the uterine lining (endometrium) and/or benign growths (fibroids) to evaluate cellular characteristics, pathological changes, and potential malignancy.
- Primary indications include:
- Abnormal uterine bleeding or heavy menstrual bleeding (menorrhagia)
- Postmenopausal bleeding or abnormal bleeding in older women
- Evaluation of thickened endometrium detected on ultrasound
- Suspected endometrial cancer or malignancy
- Monitoring of fibroid characteristics and cellular changes
- Assessment of endometrial hyperplasia or dysplasia
- Infertility evaluation and implantation assessment
- Evaluation of chronic pelvic pain or pressure symptoms
- Typical timing:
- Endometrial sampling is typically performed during the proliferative phase (after menstruation but before ovulation) or during the luteal phase, depending on clinical indication
- Procedures may be performed in office setting or operating room depending on sample collection method and complexity
Normal Range
- Normal Endometrial Findings:
- Benign endometrial tissue with normal glandular and stromal architecture
- Absence of atypical cells or dysplasia
- Normal mitotic activity appropriate for menstrual cycle phase
- Endometrial thickness: 2-16 mm depending on menstrual cycle phase (4-8 mm postmenopausal in non-hormone users)
- Normal Fibroid Findings:
- Benign smooth muscle tissue (leiomyoma) with well-organized architecture
- Low mitotic count (less than 5 mitoses per 10 high power fields)
- Absence of atypia or necrosis
- Interpretation scale:
- Negative/Normal: No pathological findings, benign tissue only
- Benign: Detected abnormality is confirmed as non-cancerous
- Atypical/Suspicious: Cellular changes warrant clinical follow-up or repeat sampling
- Malignant/Positive: Carcinoma or significant dysplasia detected, requires immediate intervention
Interpretation
- Endometrial Hyperplasia (Simple or Complex):
- Excessive proliferation of endometrial glands; simple hyperplasia carries low cancer risk (1-3%), complex hyperplasia without atypia carries moderate risk (8-29%)
- Endometrial Intraepithelial Neoplasia (EIN) or Dysplasia:
- Atypical cells present with abnormal nuclear features; significant cancer risk (20-39%) if untreated; requires aggressive management
- Endometrial Adenocarcinoma:
- Confirmed malignancy with glandular invasion; grading (Grade 1, 2, or 3) indicates differentiation level and prognosis; requires oncologic intervention
- Benign Leiomyoma (Fibroid):
- Confirmed benign smooth muscle tumor; extremely low malignant transformation risk (<0.1%); management based on symptoms and location
- Atypical Leiomyoma:
- Smooth muscle tumor with atypical features but low mitotic activity; uncertain malignant potential; requires close monitoring and possible surgical intervention
- Leiomyosarcoma:
- Malignant smooth muscle tumor with high mitotic rate (>10 per 10 HPF) and marked atypia; poor prognosis; requires aggressive surgical and oncologic management
- Endometritis or Chronic Inflammation:
- Increased inflammatory infiltrate in endometrium; may be associated with infectious or inflammatory conditions; may impact fertility
- Factors affecting interpretation:
- Menstrual cycle phase at time of sampling influences endometrial appearance and proliferation patterns
- Hormone therapy (estrogen, progesterone) may alter tissue architecture and cellular features
- Specimen adequacy and quality affect diagnostic accuracy; insufficient or fragmented samples may require repeat sampling
- Presence of blood or artifact may obscure pathological findings
- Use of immunohistochemical stains may be needed to confirm diagnosis in ambiguous cases
Associated Organs
- Primary organ system:
- Female reproductive system - specifically the uterus, its lining (endometrium), and myometrium (muscle layer containing fibroids)
- Diseases commonly associated with abnormal endometrial findings:
- Endometrial cancer (adenocarcinoma) - most common gynecologic malignancy
- Endometrial hyperplasia - pre-malignant condition
- Polycystic ovary syndrome (PCOS) - associated with anovulation and abnormal endometrial proliferation
- Chronic endometritis - often associated with infertility or recurrent miscarriage
- Asherman's syndrome - intrauterine adhesions following trauma or infection
- Diseases commonly associated with abnormal fibroid findings:
- Uterine leiomyomas (fibroids) - benign smooth muscle tumors affecting 20-40% of women of reproductive age
- Leiomyosarcoma - rare malignant smooth muscle tumor with high mortality
- Uterine adenomyosis - benign condition with myometrial invasion
- Associated risk factors for abnormal endometrium:
- Obesity - increases estrogen production and endometrial cancer risk
- Diabetes mellitus - associated with hyperinsulinemia and increased endometrial proliferation
- Hypertension - often co-exists with obesity and endometrial cancer
- Unopposed estrogen exposure - from anovulation, obesity, or hormone therapy without progesterone
- Tamoxifen use - breast cancer treatment associated with increased endometrial cancer risk
- Lynch syndrome - hereditary cancer predisposition syndrome with 40-60% endometrial cancer risk
- Potential complications of abnormal results:
- Metastatic disease - malignant endometrial findings may have already spread to lymph nodes, peritoneum, or distant organs
- Infertility - endometrial pathology may impair implantation and fertility
- Recurrent pregnancy loss - abnormal endometrial findings increase miscarriage risk
- Severe hemorrhage - fibroids or endometrial pathology may cause life-threatening bleeding
- Uterine rupture - fibroids may compromise uterine integrity during pregnancy
Follow-up Tests
- Recommended follow-up tests based on benign findings:
- Repeat pelvic ultrasound in 6-12 months to monitor for changes in fibroid size or endometrial thickness
- Hemoglobin/hematocrit testing to evaluate for anemia from chronic bleeding
- Pelvic MRI for comprehensive assessment of fibroid number, size, and location if considering conservative or surgical management
- Recommended follow-up tests based on hyperplasia findings:
- Repeat endometrial biopsy in 3-6 months to assess response to progestin therapy
- Pelvic ultrasound to evaluate for other structural abnormalities
- Metabolic panel including glucose and lipids to assess metabolic syndrome risk factors
- Weight management evaluation and counseling
- Recommended follow-up tests based on atypical/dysplasia findings:
- Urgent repeat endometrial biopsy or hysteroscopic evaluation with directed biopsy within 1-2 months
- Immunohistochemical staining (p53, MLH1, MSH2, MSH6) to assess for Lynch syndrome if not previously done
- Genetic counseling and potential genetic testing for hereditary cancer syndromes
- Pelvic MRI with contrast to evaluate for myometrial invasion
- Recommended follow-up tests based on malignancy findings:
- Urgent gynecologic oncology consultation for surgical staging and treatment planning
- Comprehensive pelvic MRI with IV contrast for local staging (myometrial depth, cervical involvement)
- CT chest/abdomen/pelvis or PET-CT for metastatic disease screening depending on grade and histology
- Tumor marker studies (CA-125, CEA) for baseline values and prognostic information
- Molecular testing (MMR deficiency, PTEN, KRAS, PIK3CA, TP53) for prognosis and treatment selection
- Complete blood count to assess baseline hemoglobin/hematocrit and establish baseline for chemotherapy tolerance
- Comprehensive metabolic panel and coagulation studies prior to surgery
- Recommended follow-up tests based on suspected leiomyosarcoma:
- Urgent surgical oncology consultation for immediate hysterectomy
- Comprehensive staging imaging: PET-CT or CT chest/abdomen/pelvis with contrast
- Specialized pathology review by sarcoma-experienced pathologist may be warranted
- Oncologic consultation for adjuvant chemotherapy considerations
- Monitoring frequency for chronic conditions:
- Simple hyperplasia without atypia: Clinical examination and imaging every 12 months; repeat biopsy if symptoms persist despite progestin therapy
- Complex hyperplasia without atypia: Clinical examination and imaging every 6-12 months; repeat biopsy at 3-6 months if inadequate progestin response
- Endometrial intraepithelial neoplasia (EIN): Very high-risk - may require hysterectomy; if conservative management chosen, imaging every 3-6 months and biopsy within 3 months
- Benign fibroids: Annual pelvic ultrasound if asymptomatic; imaging every 6 months if symptomatic
- Endometrial cancer (post-treatment): Physical examination every 3-4 months for 2-3 years, then every 6 months; imaging based on symptoms or follow-up protocol
Fasting Required?
- Fasting: NO
- Fasting is not required for endometrial or fibroid tissue biopsy. This is a tissue sampling procedure requiring direct visualization and biopsy, not a blood test requiring metabolic state control.
- Patient preparation requirements:
- Timing considerations:
- Schedule procedure after cessation of menstrual bleeding, ideally days 5-15 of menstrual cycle (unless otherwise indicated)
- For postmenopausal patients, timing is not cycle-dependent; schedule when convenient
- Pre-procedure instructions:
- Eat a light meal 1-2 hours before procedure if conscious sedation or general anesthesia planned
- Empty bladder completely immediately before procedure
- Avoid douching, vaginal intercourse, and tampons for 3-5 days before procedure
- Wear loose, comfortable clothing for easy access
- Arrange for transportation if sedation/anesthesia is used
- Medications to avoid or adjust:
- Anticoagulants (warfarin, apixaban, rivaroxaban, etc.): May require temporary discontinuation 5-7 days before procedure; consult prescribing physician and proceduralist for specific protocol
- Antiplatelet agents (aspirin, clopidogrel, ticagrelor): Continue as directed unless specifically advised by physician to discontinue
- NSAIDs: Consider discontinuing 3-5 days before procedure to minimize bleeding; acetaminophen acceptable alternative
- Antibiotic prophylaxis: May be recommended for patients with cardiac abnormalities, prosthetic valves, or immunosuppression; discuss with proceduralist
- Continue routine medications (blood pressure, cardiac, thyroid medications, etc.) as prescribed unless instructed otherwise
- Special considerations:
- Active vaginal infection: Postpone procedure until treated to avoid contamination of sample and infection dissemination
- Pregnancy: Biopsies contraindicated; use alternative imaging when endometrial evaluation needed
- Cervical stenosis or difficult anatomy: May require anesthesia or preoperative cervical dilation
- Immunocompromised patients: May require additional precautions and prophylactic coverage
- Anxiety or pain sensitivity: Discuss pain management options (topical anesthetic, systemic analgesia, conscious sedation) with proceduralist in advance
- Post-procedure instructions:
- Light vaginal spotting/bleeding for 24-48 hours is normal; heavier bleeding warrants immediate evaluation
- Mild cramping expected; use over-the-counter analgesics as needed (acetaminophen or ibuprofen)
- Avoid douching, intercourse, and tampons for 7 days post-procedure
- Resume normal activities gradually; avoid strenuous exercise for 24-48 hours

How our test process works!