Endometrial microcalcifications detected by ultrasonography: Clinical associations, histopathology, and potential etiology

Alexander M. Truskinovsky, Eugenio O Gerscovich, Curtis R. Duffield, Philip J. Vogt

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Endometrial microcalcifications are uncommon, with alleged clinical implications ranging from innocuous to ominous. We reviewed the histopathologic slides from 29 patients who had endometrial echogenic foci on pelvic ultrasound and found many endometrial microcalcifications. The extent of microcalcifications in each specimen was graded on a semiquantitative scale from 0 to 3. The mean patient age was 54 years (range, 34-81 years). The specimens included endometrial biopsies, curettages, and hysterectomies. Most of the patients had presented with abnormal vaginal bleeding. Fifteen patients (51.7%) were postmenopausal, 10 (34.5%) were premenopausal, and the rest were perimenopausal. The most frequent endometrial types were atrophic (39.5%), inactive (23.3%), and proliferative (14%). Six specimens (14%) showed benign endometrial polyps. One patient had well-differentiated endometrioid carcinoma of the endometrium without myometrial invasion. Specimens from 16 patients (55.2%) had microcalcifications. The patients with calcifications were older than those without calcifications (mean age, 60 vs. 47 years, respectively; P = 0.017). The extent of microcalcifications positively correlated with the presence of endometrial polyps (P = 0.00076), postmenopausal state (P = 0.004), atrophic endometrium (P = 0.002), and hormone replacement therapy (P = 0.013). The microcalcifications were concentric or amorphous, intraglandular or stromal. They were focally associated with minute papillary epithelial projections or with degenerated endometrial glands. Follow-up was available on 26 patients (89.7%). Except for the patient with endometrioid carcinoma, none has developed uterine, adnexal, or peritoneal malignancy. In summary, endometrial microcalcifications are histologically heterogeneous and are associated with older patient age, postmenopausal state, atrophic endometrium, and endometrial polyps. Those found incidentally by means of pelvic ultrasonography, in our experience, did not portend malignancy.

Original languageEnglish (US)
Pages (from-to)61-67
Number of pages7
JournalInternational Journal of Gynecological Pathology
Volume27
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

Calcinosis
Ultrasonography
Polyps
Endometrioid Carcinoma
Endometrium
Curettage
Uterine Hemorrhage
Hormone Replacement Therapy
Endometrial Neoplasms
Hysterectomy
Neoplasms
Biopsy

Keywords

  • Atrophic endometrium
  • Endometrial polyps
  • Endometrium
  • Microcalcifications
  • Psammoma bodies

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

Cite this

Endometrial microcalcifications detected by ultrasonography : Clinical associations, histopathology, and potential etiology. / Truskinovsky, Alexander M.; Gerscovich, Eugenio O; Duffield, Curtis R.; Vogt, Philip J.

In: International Journal of Gynecological Pathology, Vol. 27, No. 1, 01.2008, p. 61-67.

Research output: Contribution to journalArticle

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abstract = "Endometrial microcalcifications are uncommon, with alleged clinical implications ranging from innocuous to ominous. We reviewed the histopathologic slides from 29 patients who had endometrial echogenic foci on pelvic ultrasound and found many endometrial microcalcifications. The extent of microcalcifications in each specimen was graded on a semiquantitative scale from 0 to 3. The mean patient age was 54 years (range, 34-81 years). The specimens included endometrial biopsies, curettages, and hysterectomies. Most of the patients had presented with abnormal vaginal bleeding. Fifteen patients (51.7{\%}) were postmenopausal, 10 (34.5{\%}) were premenopausal, and the rest were perimenopausal. The most frequent endometrial types were atrophic (39.5{\%}), inactive (23.3{\%}), and proliferative (14{\%}). Six specimens (14{\%}) showed benign endometrial polyps. One patient had well-differentiated endometrioid carcinoma of the endometrium without myometrial invasion. Specimens from 16 patients (55.2{\%}) had microcalcifications. The patients with calcifications were older than those without calcifications (mean age, 60 vs. 47 years, respectively; P = 0.017). The extent of microcalcifications positively correlated with the presence of endometrial polyps (P = 0.00076), postmenopausal state (P = 0.004), atrophic endometrium (P = 0.002), and hormone replacement therapy (P = 0.013). The microcalcifications were concentric or amorphous, intraglandular or stromal. They were focally associated with minute papillary epithelial projections or with degenerated endometrial glands. Follow-up was available on 26 patients (89.7{\%}). Except for the patient with endometrioid carcinoma, none has developed uterine, adnexal, or peritoneal malignancy. In summary, endometrial microcalcifications are histologically heterogeneous and are associated with older patient age, postmenopausal state, atrophic endometrium, and endometrial polyps. Those found incidentally by means of pelvic ultrasonography, in our experience, did not portend malignancy.",
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