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Thickened endometrium in the postmenopausal woman: sonographic-pathologic correlation
S Sheth1, U M Hamper, R J Kurman
1Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21205.
Radiology
|April 1, 1993
Summary
Postmenopausal women with thickened endometria (greater than 5 mm) can have various conditions. Sonographic patterns may help distinguish benign endometrial changes from malignant lesions.
Area of Science:
- Gynecologic Imaging
- Pathology
- Oncology
Background:
- Endometrial thickness in postmenopausal women requires careful evaluation.
- Pelvic sonography is a key diagnostic tool.
Purpose of the Study:
- To correlate sonographic findings with histopathologic diagnoses in postmenopausal women with thickened endometria.
- To assess the utility of sonographic patterns in differentiating benign from malignant endometrial conditions.
Main Methods:
- Correlative sonographic and histopathologic analysis.
- Inclusion of 35 postmenopausal women with endometrial thickness > 5 mm.
- Exclusion of women on estrogen replacement therapy.
Main Results:
- Four distinct sonographic patterns were identified.
- Pattern 1: Echogenic endometrium with cysts (polyps, hyperplasia, atrophic glands).
- Pattern 2: Homogeneous echogenic endometrium (proliferative, adenomyomatous polyp).
- Pattern 3: Irregular, inhomogeneous endometrium (carcinoma, hyperplasia with atypia, clots).
- Pattern 4: Thin endometrium with fluid (atrophic).
Conclusions:
- Endometrial thickness > 5 mm in postmenopausal women is linked to diverse pathologies.
- Sonographic pattern subclassification aids in differentiating benign from malignant endometrial lesions.