Endometrial Biopsy: a Karyometric and Stereological Study
Aiad Abdullah Abdulrazak
Acta Inform Med. 2012; 20(2): 94-98

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Background: Diagnosis of premalignant endometrial lesions is a major challenge to pathologists. The D-score system is more reproducible than the WHO scheme, however it is not widely available, this study attest a simple custom-made workstation for estimation of the “D-score”. Material and methods: Fifteen endometriam with low grade hyperplasia, fifteen proliferative and eight secretory phase endometria were analyzed by light microscopy and stereology. We determined the volume and surface density glands & stroma. karyometric parameters of the endometrial glandular epithelial cells were estimated. D-score was calculated from some architectural & karyometric parameters. Results: The volume of stroma (VPS) was significantly higher in proliferative than secretory and hyperplastic endometria. The glandular surface density were higher in secretory endometria than proliferative and hyperplastic endometria, however, the differences was statistically insignificant. The ratio of longest nuclear axis to shortest nuclear axis was significantly less in secretory than proliferative and hyperplastic endometria. Secretory endometria also have significantly lower mean values of shape factor & significantly higher mean values of contour index than proliferative and secretory endometria. 67% of hyperplastic endometria show D-score values < 0. Conclusion: it seems feasible to estimate D-score using a semi-automated workstation based on the simple stereologic and morphometric principles.


1. Ries LAG, Melbert D, Krapcho M, et al. SEER cancer statistics review, 1975-2005. Bethesda, National cancer institute, 2008 online, http://seercancergo/csr/1975_2005/.

2. Baak JP, Mutter GL. EIN and WHO94. J Clin Pathol. 2005; 58: 1-6.

3. Winkler B, Alvarez S, Richart RM, et al. Pitfalls in the diagnosis of endometrial neoplasia. Obstet Gynecol. 1984; 64: 185-194.

4. Mutter GL. Diagnosis PF premalignant endometrial disease. J Clin Pathol. 2002; 55: 326-331.

5. Ørbo A, Baak JP, Kleivan I. et al. Computerised morphometrical analysis in endometrial hyperplasia for the prediction of cancer development. A long term retrospective study from northern Norway. J Clin Pathol. 2000; 53: 697-703

6. Izadi-Mood N, Yarmohammadi M, Ahmadi SA. Reproducibility determination of WHO classification of endometrial hyperplasia/well differentiated adenocarcinoma and comparison with computerized morphometric data in curettage specimens in Iran. Diagnostic Pathology 2009; 4: 10.

7. Acer et al. Estimation of the Eyeball and Orbital Volume. Balkan Med J. 2011; 28: 184-188.

8. Picoli LC, Watanabe I, Lopes RA et al. Effect of cadmium on the floor of the mouth on rats during lactation. Braz Oral Res. 2004; 18(2): 105-109.

9. Dardick I, Douglas CR. Follicular Center Cell Lymphom: Morphologic Data Relating to Observer Reproducibility. Cancer. 1986; 58: 2477-2484.

10. Avvad-Portari E, Gomes ND, Mandarim-de-Lacerda CA. Simple hyperplasia versus proliferative endometrium: stereological study. Jornal Brasileiro de Patologia e Medicina Laboratorial Rio de Janeiro. 2003; 39(1): 73-79.

11. Baak JPA. et al. Discrimination of hyperplasia and carcinoma of the endometrium by quantitative microscopy – a feasibility study. Histopathology. 1981; 5: 61-68.

12. Hecht JL, Ince TA, Baak JP. Prediction of endometrial carcinoma by subjective endometrial intraepithelial neoplasia diagnosis. Modern Pathology. 2005; 18: 324-330.

13. Mahovlic V, Ovanin-Rakic A, Škopljanac-Macina L. et al. Digital Morphometry of Cytologic Aspirate Endometrial Samples. Coll Antropol. 2010; 34(1): 45-51.

14. Skaarland E. Morphometric analysis of nuclei in epithelial structures from normal and neoplastic endometrium: a study using the Isaacs cell sampler and Endoscann instruments. J Clin Pathol. 1985; 38: 496-501.

15. Skaarland E. Nuclear size and shape of epithelial cells from the endometrium: lack of value as a criterion for differentiation between normal, hyperplastic, and malignant conditions. J Clin Pathol. 1985; 38: 502-506.

16. Dutta S, Basu A, Mukherji B. Nuclear Morphometry of Perimenopausal Endometrium in Nepali Population. AJMS. 2011; 4(3): 247-253.

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