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An audit of endometrial hyperplasias at the Lagos University Teaching Hospital
O O Dawodu1, N Z Ikeri2, A A Banjo3
1Department of Anatomic and Molecular Pathology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria.
Insights
The World Health Organization (WHO) 2014 classification simplifies endometrial hyperplasia diagnosis. This audit found hyperplasia without atypia most common, with high diagnostic concordance using the new WHO system.
Area of Science:
- Gynecologic Pathology
- Histopathology
- Oncology
Background:
- Endometrial hyperplasias have historically faced diagnostic challenges due to varied terminology and unclear pathophysiological mechanisms.
- The 2014 World Health Organization (WHO) classification aimed to resolve these issues by providing a standardized framework.
Purpose of the Study:
- To audit and standardize endometrial hyperplasia diagnoses within an institution.
- To evaluate the application of the WHO 2014 classification in clinical practice.
Main Methods:
- Retrospective review of endometrial hyperplasia cases diagnosed between 2007 and 2011.
- Re-evaluation of slides and request forms using the WHO 2014 classification criteria.
Main Results:
- Endometrial hyperplasia without atypia constituted the vast majority (95.5%) of cases, predominantly in the 5th decade.
- High concordance rates were observed: 74.5% for hyperplasia without atypia and 100% for atypical hyperplasias compared to prior diagnoses.
Conclusions:
- The WHO 2014 classification standardizes terminology for endometrial hyperplasias.
- This classification reflects current understanding of genetic changes, aiding prognostication and treatment decisions.
Introduction:
There has been much controversy and confusion surrounding the endometrial hyperplasias stemming from the use of a wide variety of terminologies and also from the pathophysiologic mechanisms underlying the various entities. The current classification by the World Health Organization (WHO) published in 2014 clarifies these issues.
Objective:
The aim of this study, therefore, was to audit and standardize cases of endometrial hyperplasia diagnosed in our institution from 2007 to 2011.
Materials And Methods:
The slides and request forms of cases diagnosed as endometrial hyperplasias at the Department of Anatomic and Molecular Pathology from January 1, 2007, to December 31, 2011 were retrieved, reviewed, and reported according to the WHO 2014 classification scheme.
Results:
Hyperplasia without atypia accounted for the vast majority of cases (95.5%) and was the most common in the 5th decade. Concordance rates of 74.5% and 100% were found between endometrial hyperplasias without atypia and atypical hyperplasias with their previous diagnoses, respectively.
Conclusion:
The WHO classification scheme standardizes and simplifies the terminology used in the diagnosis of endometrial hyperplasias, while reflecting, at the same time, the current understanding of genetic changes that provide information necessary for prognostication and treatment.
