3%). Can you please suggest is the D&C report normal or not. , proliferative endometrium. Learn how we can help. Metaplasia is defined as a change of one cell type to another cell type. Proliferative endometrium was seen in 14. There is considerable overlap between these phases so the diagnosis of. Disordered proliferative phase was the commonest (16%. A proliferative endometrium is a normal part of healthy uterine function when it occurs during the first half of the menstrual cycle. The differ in that the former involves tissue growth into the muscular wall of the uterus, while the latter involves tissue growth outside of the uterus into surrounding organs. Almost all hyperplasia is seen in the context of proliferative-type endometrium. Proliferative endometrium has a fuller,. Summary. refers to a proliferative phase endometrium that does not seem appropriate f or any one time. The uterine cycle is divided into three phases: the menstrual phase. In this phase, tubular glands with columnar cells and surrounding dense stroma are proliferating to build up the endometrium following shedding with previous. Symptoms?: I assume this was a result of an endometrial biopsy done for heavy or irregular bleeding. Most endometrial biopsies from women on sequential HRT show weak secretory features. resembling proliferative phase endometrium. Disordered Proliferation. cystically dilated glands are predominantly detected in the atrophic endometrium of postmenopausal women and in disordered proliferative endometrium, which is also. Non-physiologic, in which the endometrium functionalis undergoes collapse, usually after cessation of exogenous hormonal therapy or intrinsic defects in normal follicle/corpus luteum progression (follicular/corpus luteum failure). tubal/eosinophil hyperpla. 00 - other international versions of ICD-10 N85. Cancer in situ of uterus; Cancer in situ, endometrium; Carcinoma in situ of uterus. 8% cases in the present study, this is in contrast to other studies where a substantially higher incidence of 25. Discussion. Jane Van Dis answered. 5 mm in thickness, and the surface and glands are lined by a low columnar to cuboidal epithelium devoid of either proliferative or secretory activity, which. Disordered proliferative pattern resembles a simple hyperplasia, but the process is focal rather than diffuse. disordered proliferative endometrium. This diagnosis means that after examining your tissue sample under the microscope, your pathologist saw irregular and dilated endometrial glands in the proliferative phase (growing phase). , 7%. In this well-phenotyped population of healthy women, obesity was associated with significant endometrial proliferative phase proteomic differences affecting predominantly hormonal and immunological pathways. Other noninflammatory disorders of uterus, except cervix (N85) Benign endometrial hyperplasia (N85. A 40-year-old female asked: Would disordered proliferative endometrium with a strong family h/o ovarian and uterine. A Verified Doctor answered. 8 Atrophic endometrium; 7. 2; median, 2. 0001) and had a higher body mass index (33. Metaplasia in Endometrium is diagnosed by a pathologist on. 7%). Endometrial hyperplasia (EH) is a spectrum of morphological changes ranging from a slightly disordered pattern seen in the late proliferative phase of the menstrual cycle to the irregular proliferation of the endometrial glands with an increase in gland-to-stroma ratio leading to thickening of the endometrium []. Endometrial hyperplasia tends to occur in people who are transitioning to menopause or who have gone through menopause. 4%), and endometrial cancer in 2 women (1. 9 Ablated endometrium;weakly proliferative endometrium with occasional mitotic figures and a thin functionalis layer. with tubal diagnosis condensation) phase metaplasia) Disordered proliferative endometrium endometrium. And you spoke to someone at the Dept. 5 years; P<. N85. Symptoms of both include pelvic pain and heavy. Symptoms?: I assume this was a result of an endometrial biopsy done for heavy or irregular bleeding. Proliferative endometrium on the other hand was seen in only 6. Glands out of phase Irregular gland architecture. 74% and 26. 0001). As a result of the anovulation, the corpus luteum does not develop, culminating in relative increase in estrogen levels and a relative decrease in progesterone levels. Contact your doctor if you experience: Menstrual bleeding that is heavier or longer-lasting than usual. 1 With. Eosinophilic and Ciliated Cell Metaplasia in Endometrium is a type of metaplasia noted in the uterine corpus. Early diagnosis and treatment of EH (with or without atypia) can prevent progression to. There were no overtly. One should be aware of this. Hence, it is also known as Metaplastic Changes in Endometrial Glands. Disclaimer: Information in questions answers, and. 6 kg/m 2; P<. Disordered proliferative endometrium is a condition where the endometrial cells are prepared for attachment of a fertilized egg, but the growth is disordered. During the proliferative phase, the endometrium responds to the endocrine environment to undergo extensive proliferation. 2. Ralph Boling answered. 0 mm in thickness, so by the late proliferative phase, a biopsy obtains a moderate amount of tissue. The majority of disordered proliferative endometrium had plasma cells (61% grade 1, 17% grade 2) all seen on methyl green pyronin staining only. Disordered proliferative endometrium can cause spotting between periods. This diagnosis means that after examining your tissue sample under the microscope, your pathologist saw irregular and dilated endometrial glands in the proliferative phase (growing phase). The 2024 edition of ICD-10-CM N85. Glands are straight and tubular without mitotic figures or pseudostratification. Normal proliferative phase endometrial smears show large tissue fragments with tubular lumen with in it. The metaplasia doesn't mean anything significant, and the glandular and stromal breakdown. N85. Read More. 8 Atrophic endometrium; 7. The cells of the endometrium can proliferate abnormally, causing disordered proliferation. 3. Disordered or dyssynchronous endometrium suggests ovulatory dysfunction. The secondary histologic features of chronic endometritis like gland architectural irregularity, spindled stroma, stromal edema and hemorrhage with the. 6% of cases. Women with a proliferative endometrium were younger (61. New blood vessels develop and the endometrial glands become bigger in size. Can you please suggest is the D&C report normal or not. 3. As a result of the anovulation, the corpus luteum does not develop, culminating in relative increase in estrogen levels and a relative decrease in progesterone levels. There's been a Bank Holiday which usually delays issues. Figure [Math Processing Error] 22. For the cervix curettage it says "predominantly disordered proliferative endometrium w/ metaplastic change, endometrial polyp fragments and scanty endocervical mucosal fragments w/ focal immature squamous metaplasia. of PTEN protein in patients with endometrial intraepithelial neoplasia compared to endometrial adenocarcinoma and proliferative phase. Our study provides preliminary evidence that the DNA flow. ENDOMETRIUM, ASPIRATION: - EARLY PROLIFERATIVE PHASE ENDOMETRIUM WITH SOME SHEDDING (APOPTOTIC CELLS, INFILTRATING NEUTROPHILS, BALLS OF CONDENSED ENDOMETRIAL STROMA). In some cases, the endometrium thickens too much, leading to excessive endometrial tissue in the uterus. Among the normal cyclical patterns, the proliferative phase endometrium was documented as the commonest one in most of the studies except for the study done by Sajitha et al. The primary symptom of endometrial hyperplasia is abnormal menstrual bleeding. In a study of 111 premenopausal women with abnormal uterine. How many days is a normal mestrual cycle? The average menstrual cycle is 28 days. Doctoral Degree. The last menstrual period should be correlated with EMB results. 3. N85. [1] Libre Pathology separates the two. No evidence of endometrium or malignancy. 6 Normal endometrium. Transition from disordered proliferative-phase endometrium (with subtle architectural alterations) to SH (with irregularly shaped, cystically dilated glands) may be seen. A result of disordered or crowded glands is common with anovulatory cycles due to prolonged estrogen stimulation without postovulatory progesterone exposure. and extending through the later, luteal, phase, progesterone elaborated. Objective: This study aimed to report on the long-term outcome of postmenopausal women who received a diagnosis of proliferative endometrium. 5 mm up to 4. EMB results can reveal important information regarding the menstrual cycle. It is a. Other significant pathologies included POCs 24%, chronic endometritis 10% and polyps 10%. . Furthermore, 962 women met the inclusion criteria. 1. The cytological features of the detached endometrial fragments that reflect the histological architecture of EGBD are described below. 9 vs 30. IHC was done using syndecan-1. e. Stromal staining of Ki67 was found to be more apparent in the secretory phase, however, it was found to be lower than that of the endometrial glands in the proliferative phase. 63 Products of Conception 1 0. It also refers to a proliferative phase endometrium that does not seem appropriate for any one time in the menstrual cycle, but is not abnormal enough to be considered hyperplastic. The events of the uterine cycle are regulated by the estrogen and progesterone produced by the ovaries during the ovarian cycle. It is of note that the authors of this study combined tissue samples of the late secretory and menstrual phases into a. If this normal process ever leads to the unusual growth of endometrial cells, it’s referred to as disordered. Disordered proliferative endometrium in present study accounted for 7. A slightly disordered endometrium is a form of cancer. 9%), disordered proliferative endometrium 200 (8. EH represents a spectrum of irregular morphological alterations, whereby abnormal proliferation of the endometrial glands results in an increase in gland-to-stroma ratio when compared to endometrium from the proliferative phase of the cycle (Ellenson et al. This condition is detected through endometrial biopsy. [13 14] In our study we noted peak glandular positivity for Bcl-2 in cyclical PE, similar to the findings of Vaskivuo et al. 7%), simple cystic. Proliferative phase 54 34. Ed Friedlander and 4 doctors agree. A proliferative endometrium in itself is not worrisome. 1%), carcinoma (4. Proliferative phase endometrium: 42%: Simple hyperplasia: 26%: Simple hyperplasia with atypia: 23%: Complex hyperplasia: 16%: Complex hyperplasia with atypia: 42%: WHO system of 1994 - detail articles. Disordered proliferative endometrium is an exaggeration of the normal proliferative phase cause by failed ovulation or minor prolongation of estrogen stimulation. Endometrial hyperplasia is a condition that causes. also known as a period), nine days for the proliferative phase (when the endometrium is developing), zero days for ovulation (when a ripe ova, or egg cell, is deposited from an. Cystic atrophy of the endometrium - does not have proliferative activity. D & C report shows no malignancy is there. Nontumor: abnormal uterine bleeding adenomyosis / adenomyoma Arias-Stella reaction atrophy disordered proliferative endometrial metaplasia endometrial polyp endometritis exogenous hormones histology of specimens from gender affirming surgery in individuals assigned female at birth. 7% cases comparing favorably with 14% and 22% in other studies. Disordered or dyssynchronous endometrium suggests ovulatory dysfunction. (b) On CD10 immunohistochemistry, the stroma stains positive,. Irregular - may be seen in secretory phase endometrium, menses, disordered proliferative endometrium (focal), simple endometrial hyperplasia (diffuse). Endometrial carcinoma was seen in 4 (1. Normal Proliferative Phase Endometrium: The glands are spaced out (left panel) with ample stroma in between (gland:stroma ratio <1). The endometrium gradually thickens throughout menstrual cycle phases: from a thin 1–4 mm ET just after menstruation to 5–7 mm during proliferative phase, then up to 11 mm within the late proliferative (periovulatory) phase, to the maximal thickness during mid-secretory phase of up to 16 mm. Normal cyclical endometrium was seen in 165 (40. 00 became effective on October 1, 2023. This can be taken in several forms, including pill, shot, vaginal cream, or intrauterine device. 9%), endometrial hyperplasia in 25 women (21. Postmenopausal bleeding. A range of conditions. Article Text. Doctor of Medicine. Normal. After menstruation, proliferative changes occur during a period of tissue regeneration. Applicable To. (16) Lower. Endometrial hyperplasia was the most common histopathological finding and was seen in 25% patients, followed by secretory endometrium in 16. 4% cases. A note from Cleveland Clinic. Polyp was present in 7. The follicle then transforms into the corpus luteum, which secretes. Endometrial cells have an insufficient supply of glucose, leading to disordered endometrial development. 65%). Lower panels: images of endometrium in the secretory phase (subject E8). EMCs. The endometrium in the background (a) shows secretory changes, but a gland in the central field of the left piece is an irregular cystic gland lined by proliferative-type epithelium (b). This is the American ICD-10-CM version of N85. The follicular phase of the female menstrual cycle includes the maturation of ovarian follicles to prepare one of them for release during ovulation. Utility of ki-67, p53, bcl-2 and cox-2 biomarkers for low-grade endometrial cancer and disordered proliferative/benign hyperplastic endometrium by imprint cytology. 4. 72 mm w/ polyp. Morphometric parameters were high in endometrial hyperplasias and endometrial carcinomas when compared to disordered proliferation and irregular shedding. Disordered proliferative endometrium is an exaggeration of the normal proliferative phase without significant increase in the overall ratio of glands to stroma and is due to persistent estrogen stimulation. The endometrium is the fleshy tissue in the womb that becomes a rich bed of blood vessels that would support a pregnancy, building during the proliferative (growing) phase before later dissolving into menstrual flow when. "Exodus" pattern is a term used to describe exfoliation of endometrial cells during the proliferative phase. 8% cases in the present study, this is in contrast to other studies where a substantially higher incidence of 25. Plasma cells have also been noted in hormonally mediated endometrial disorders in association with gland architectural changes (“disordered proliferative” and “anovulatory” patterns), and stromal breakdown. Disordered Proliferation. The differ in that the former involves tissue growth into the muscular wall of the uterus, while the latter involves tissue growth outside of the uterus into surrounding organs. Once ovulation occurs (and an egg is. Endometritis; Endometrium; Endometrium with changes due to exogenous hormones; Endometrium with psammoma bodies; Endometrium with squamous morules; P. Attention to the presence of artifacts (e. Adenomyosis and endometriosis are chronic conditions that affect the endometrium, the tissue lining of the uterus. The pathognomonic feature is cystic changes of individual glands distributed randomly throughout the entire hormonally responsive region of the endometrium (superficial. (WC)The proliferative endometrium is what is shed from the uterus when a woman has her cycle. DDx: Endometrial hyperplasia with secretory changes. People between 50 and 60 are most likely to develop endometrial hyperplasia. Complex endometrial hyperplasia - has increased gland-to-stroma ratio. In other words, estrogen stimulates the endometrium to grow and thicken. Your endometrial biopsy results is completely benign. 5%) endometrium (Fertil Steril 2021;115:1312, Int J Gynecol Pathol 2019;38:520) Focal stromal decidual-like changes Transitional cell metaplasia of ectocervical and transformation zone epithelium or cervical atrophy ( Obstet Gynecol 2021;138:51 )What does this mean? endometrium, biopsy: disordered proliferative endometrium with associated simple (cystic) hyperplasia. Glands pseudostratified? Pseudostratified glands are normal in the proliferative phase endometrium, hyperplasias, malignancy. The primary symptom of disordered proliferative endometrium is bleeding between menstrual periods. doi: 10. HYPERPLASIA) VERSUS DISORDERED PROLIFERATIVE ENDOMETRIUM •All part of a spectrum •Probably no (at most minimal) risk of progression •Don’t worry too much about distinction- not clinically important (don’t let clinicians tell you it is) •Tend to call disordered proliferative in perimenopausal years; tend to call hyperplasia In the human endometrium, estrogen drives tissue repair and epithelial proliferation during the proliferative phase and estrogen and progesterone promote thickening of the endometrium following ovulation. Endometrial hyperplasia (EH) is categorized into two groups: EH without atypia and EH with atypia (also referred to as endometrial. BILLABLE Female Only | ICD-10 from 2011 - 2016. 45%), proliferative endometrium in 25cases (20. Kayastha7 and other studies. Over ten years if not treated, this can raise the risk of uterine malignancy. Disordered proliferative endometrium is a non-cancerous change that develops in the tissue that lines the inside of the uterus. 6%). 3%). Unlike endometrial polyp, fragments of anovulatory endometrium feature uniform and densely cellular stroma without fibrosis and lack thick-walled vessels. 7%) followed by secretory phase (22. Disordered proliferative endometrium; E. Should be easily regulated with hormones such as low dose b. N85. In addition, a significant number show. N85 - Other noninflammatory disorders of uterus, except cervix. 9 vs 30. Disordered proliferative endometrium is a non-cancerous change that develops in the tissue that lines the inside of the uterus. 1%) each. What do the results of my endometrial biopsy mean? Here are some words and phrases you might see on your biopsy results: Proliferative endometrium; Atrophic. Secretory phase endometrium was found in 13. 56%). The highest correlation was seen in the endometrial phase, followed by complex and then by simple hyperplasia. Report attached. Disordered proliferative pattern lies at one end of the spectrum of. The main hormone during this phase is estrogen. In the early proliferative phase of the uterine cycle (days 4–7), the endometrium is linear, echogenic, and thin (Fig. Although the proliferation of the endometrium is part of a healthy cycle, things can go wrong during this phase. Hence, it is also known as Metaplastic Changes in Endometrial Glands. 1%) each. read more. 95: Disordered proliferative: 14: 15. Report attached. 4%) and chronic endometritis. The abnormal bleeding in the proliferative phase could be . A. This is discussed in detail separately. N85. Cases were reviewed by a second pathologist whenever necessary. This study was performed to assess the long-term outcomes of postmenopausal women harboring PE on endometrial sampling. Clinical and imaging features of polypoid endometriosis differ from classic endometriosis. I'm 51, no period 8 months, spotting almost every day for year. The Proliferative Phase. Endometrial hyperplasia is a disordered proliferation of endometrial glands. Disordered proliferative endometrium with glandular and stromal breakdown. 7% and atrophic endometrium in 2. Norm S. Women with a proliferative endometrium were younger (61. Endometrial polyps (EMPs) are common exophytic masses associated with abnormal uterine bleeding and infertility. The disordered proliferative endometrium/polyps, hyperplasia, and malignant pathology were found in 15. , 2011; Kurman et al. 9 vs 30. The specimens were all from patients with dysfunctional uterine bleeding and include 30 poorly active endometrium, 16 atrophic endometrium, 2 weakly proliferative endometrium, 3 disordered. ICD-10-CM Coding Rules. Early diagnosis and treatment of EH (with or without atypia) can prevent progression to. It is also seen in exogenous estrogen therapy and is a result of dys-synchronous growth of the functional is. Where there were discrepancies between assignment as disordered proliferative endometrium or HwA, cases were upgraded into the HwA category. Management of SIL Thomas C. IHC was done using syndecan-1. A nested case-control study of EH progression, using extensive histopathology reports, concluded that AH was 14 times more likely to progress to endometrial carcinoma as compared to the women that presented with disordered proliferative endometrium without hyperplasia. My mother's d&c report says disordered proliferative endometrium. Obstetrics and Gynecology 27 years experience. The normal cyclical endometrium comprising the proliferative phase endometrium (35%), secretory phase endometrium (18. Disordered proliferative phase was the commonest (16%) functional cause of abnormal bleeding and diagnosis. During the proliferative phase , the endometrium grows from about 0. be encountered in a disordered. Just reading about or looking for understanding of "weakly. Applicable To. Endometrial hyperplasia (EH) is categorized into two groups: EH without atypia and EH with atypia (also referred to as endometrial intraepithelial neoplasia [EIN]). The average age of menopause is 51 years old. The findings in endometrial biopsies taken for abnormal uterine bleeding can show a wide range of appearances that reflect the cyclical changes in the endometrium in women during their reproductive years; accordingly, the histopathological diagnosis provides a description of the features observed microscopically (e. EH with atypia is neoplastic and may progress or coexist with endometrial carcinoma. N85. The last menstrual period should be correlated with EMB results. Objective: This study aimed to report on the long. In peri-menopausal age group, the proliferative endometrium was the most common finding observed in 30 cases (34. 16-Day Endometrium (Postovulatory Day 2) Vacuole Phase of Secretory Endometrium (17 to 19 days; Postovulatory Day 3 to 5). Conclusions: The prevalence of abnormal uterine bleeding was found to be higher in comparison to other studies. Disordered proliferative endometrium was the most common histopathological finding followed by secretory. Weakly proliferative endometrium suggests there has still been a little estrogen present to stimulate the endometrium, whether from your ovaries, adrenals, or from conversion in fat cells. An initial proliferative phase leading to hypertrophy and a second or remodelling phase, characterized by increasing morphokinetic and biochemical alterations of gland cells. See moreDisordered proliferative endometrium is a benign condition of abnormal proliferative endometrium with architectural changes due to persistent unopposed estrogen stimulation. Endometrium in proliferative phase, secretory phase, endometrial polyps, and disordered proliferative endometrium were studied for the presence of plasma cells. Furthermore, 962 women met the inclusion criteria. Disordered proliferative endometrium accounted for 5. Is there Chance of malignancy in future. The endometrium measures less than 0. Five days for the menstrual phase (when a woman's endometrium is being expelled, also known as a period), nine days for the proliferative phase (when the endometrium is developing), zero days for ovulation (when a ripe ova, or egg cell, is. Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the. The 2024 edition of ICD-10-CM N85. The disordered proliferative phase pattern usually is an extension of anovulatory cycles due to persistent estrogen stimulation. Images Stromal staining of Ki67 was found to be more apparent in the secretory phase, however, it was found to be lower than that of the endometrial glands in the proliferative phase. Stromal cells are attached to the periphery. The FBLN1 protein is expressed in the stromal cells of human endometrial tissues and the FBLN1 mRNA levels are higher during the secretory phase than during the proliferative phase. 2. Secretory phase endometrium was found in 13. In women in the mid and late-proliferative phase, the endometrial thickness was significantly greater in those with EPs than in. Analysis of postmenopausal women who underwent endometrial sampling from 1997 to 2006 and were followed clinically through. hyperplasia and the proliferative endometrium except for Sv[outer] and Lv[gland]. The proliferative phase has a variable length from 10 to 20 days, with an ideal duration of 14 days. Most of the patients were in age group. The aim of this review is to update current issues and provide a classification with a practical clinicopathological approach. Endometrial ablation – Surgical destruction of the endometrium. Proliferative phase (days 6 - 14): Stratum functionalis is regenerated by cells from stratum basalis Disordered proliferative phase. 8 - other international versions of ICD-10 N85. 4% cases. Pathology 51 years experience. Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Metaplasia in Endometrium is a common benign condition that occurs in the glands of the endometrial lining (of the uterus). g. Not having a period (pre-menopause) During the proliferative phase, the endometrium responds to the endocrine environment to undergo extensive proliferation. commonest finding observed in the study was secretory phase endometrium (25. Furthermore, 962 women met the inclusion criteria. Proliferative endometrium is a very common non-cancerous change that develops in the tissue lining the inside of the uterus. N00-N99 - Diseases of the genitourinary system. Most of the studies reported an increased positivity for Bcl-2 in the proliferative phase endometrium as compared to other phases of the menstrual cycle. …were disordered proliferative endometrium (15. Created for people with ongoing healthcare needs but benefits everyone. Disordered proliferativeThe other diagnoses, which accounted for the rest of the functional causes of atypical uterine bleeding, were disordered proliferative endometrium 15 cases (6. Approximately 15% show proliferative activity, although this figure may be less if more than nine days of. The 2024 edition of ICD-10-CM N85. Disordered proliferative endometrium, abbreviated DPE, is an abnormal endometrial finding with some features of simple endometrial hyperplasia . Obstetrics and Gynecology 20 years experience. . , 2011; Kurman et al. 2014; 42:134–142. The primary symptom of endometrial hyperplasia is abnormal menstrual bleeding. 16 Miranda et al. The commonest finding observed in the study was proliferative phase endometrium (37. Endometrial hyperplasia was the most common histopathological finding and was seen in 25% patients, followed by secretory endometrium in 16. Results: Out of 100 cases studied, 37% were found out to be secretory endometrium, 20% proliferative endometrium, 6% disordered endometrial glands, 3% simple hyperplasia without atypia, 5% complex. Cystically dilated glands with outpouchings. Disordered proliferative endometrium characterized by few dilated and cystic (red arrow) glands amid tubular proliferative phase glands (blue arrow) (HE stain, ×10) ATROPHY Atrophy is an important cause of abnormal and recurrent uterine bleeding in postmenopausal patients, found in 25%–48% or more of menopausal women coming for a biopsy. Disordered proliferative endometrium ] is an exaggeration of the normal proliferative phase without significant increase in the overall ratio of glands to stroma and is due to persistent oestrogen stimulation. 79 Pill endometrium 5 3. The uterus is the fusion product of the embryologic paramesonephric (müllerian) ducts. 06 Hyperplasia 6 3. 8%), luteal phase defects 3 cases (1. 5%) revealed secretory phase. Endometrial hyperplasia was the most common histopathological finding and was seen in 25% patients, followed by secretory endometrium in 16. 5% of the cases, with the highest incidence in the age. At this time, ultrasound exhibits a high echo. , 1996). , a discrepancy between proliferative. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.