Background: Hysteroscopy enables direct visualization of the endometrial cavity via the cervix with an endoscope and a light source. Diagnostic and therapeutic indications include: abnormal uterine bleeding; postmenopausal endometrial thickening; removal of endometrial polyps; resection of submucosal myomata; incision of uterine septa; directly visualizing and removing intrauterine foreign bodies; hysteroscopic sterilization; recurrent miscarriages; endocervical lesions; lysis of uterine synechiae; abnormal hysterosalpingography; and infertility. Cases:Case 1: A 73-year-old postmenopausal female presented with right lower-quadrant abdominal fullness, and she had a thickened endometrium (9.4 mm) on noted on ultrasound. An outpatient endometrial biopsy was attempted but was unsuccessful because the patient had cervical stenosis. She underwent hysteroscopy and dilation and curettage (D&C). Hysteroscopy revealed the presence of lesions in the endometrial cavity, and samples of these lesions showed focal marked nuclear atypia histopathologically. Case 2: A 61-year-old postmenopausal female with a history of leiomyomata uteri, 2 ectopic pregnancies, and human papilloma virus, presented with postmenopausal bleeding. On ultrasound, her endometrium noted to be slightly irregular but was normal in texture and thickness (4.8 mm). She underwent hysteroscopy and D&C. Hysteroscopy showed the presence lesions in the endometrial cavity, and samples of these lesions showed mitotic figures histopathologically. Results: Both patients elected to undergo robot-assisted hysterectomy and bilateral salpingo-oophorectomy. Conclusions: On hysteroscopy, these 2 patients had yellowish endometrial lesions, and biopsy revealed the presence of atypical cells. These characteristic hysteroscopic findings may possibly be associated with endometrial nuclear atypia. It would be useful to investigate similar hysteroscopic findings with histopathology. (J GYNECOL SURG 31:180)
Pato-MosqueraM, Vazquez-RodriguezM, Perez-AdanM, Garcia-GarciaMJ, Blanco-PerezS. Diagnostic hysteroscopy indications and results in Complexo Hospitalario Universitario De Ourense. Ginecol Obstet Mex, 2013; 81:382.
7.
PatilSG, BhuteSB, InamdarSA, AcharyaNS, ShrivastavaDS. Role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathologic correlation. J Gynecol Endosc Surg, 2009; 1:98.
8.
GarutiG, CellaniF, GarziaD, ColonnelliM, LuertiM. Accuracy of hysteroscopic diagnosis of endometrial hyperplasia: A retrospective study of 323 patients. J Minim Invasive Gynecol, 2005; 12:247.
9.
TrioloO, AnticoF, PalmaraV, BenedettoV, PanamaS, NicotinaPA. Hysteroscopic findings of endometrial carcinoma—evaluation of 104 cases. Eur J Gynaecol Oncol, 2005; 26:434.
10.
BaratiM, MasihiS, MorameziF. Hysteroscopic view of endometrial hyperplasia. Pak J Med Sci, 2008; 24:65.
11.
PolyzosNP, MauriD, TsiorasS, MessiniCI, ValachisA, MessiniIE. Intraperitoneal dissemination of endometrial cancer cells after hysteroscopy: A systematic review and meta-analysis. Int J Gynecol Cancer, 2010; 20:261.
12.
DamiãoRS, LopesRGC, SantosES, LippiUG, FonsecaEB. Evaluation of the risk of spreading endometrial cell by hysteroscopy: A prospective longitudinal study. Obstet Gynecol Int, 2009; 2009:397079.
13.
SoucieJE, ChuPA, RossS, SnodgrassT, WoodSL. The risk of diagnostic hysteroscopy in women with endometrial cancer. Am J Obstet Gynecol, 2012; 207:71.e1.
