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Postmenopausal bleedingFrom: Alexandra Borisova (treatment@mtu-net.ru)Wed Feb 2 07:04:01 2000
54 y.o. patient presented with scanty vaginal bloody discharge for 3 days. Menopuase for 2 years. Normal weight. No HRT. On pelvic exam: cervix - clean, small sized uterus, adnexa - not palpated. On TVUS - irregular endometrial structure, thickness 3-6 mm. Hysteroscopy and D&C were done. On hysteroscopy - atrophic endometrium without any focal lesions was seen. However, histology conclusion was following: prolifirative endometrium, some fragments with signs of secretory phase, in some - patterns of hyperplasia present. I`am confused with this histology conclusion. Is it possible prolifirative and secretory endometrium are present at the same sample? What kind of treatment/follow-up would you recommend for this patient? In my opinion, as D&C was done and endometrial hyperplasia (if it was really present)was removed, patient needs expectant observation and repeated TVUS in 3 months. If again endometrial thickness more than 4 mm - TVH should be done.
-- Alexandra Borisova, MD AEA International - SOS Assistance International Medical Clinic Russia, Moscow.
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