Endometrial Polyps

An endometrial polyp is a localized overgrowth of endometrial glands and stroma with a vascular core. It projects into the uterine cavity from a broad base or a stalk, rather than representing uniform thickening of the entire endometrium. In the PALM-COEIN framework for abnormal uterine bleeding, a polyp is a structural, or PALM, cause. The lesion’s glands and blood vessels are fragile and poorly coordinated with the surrounding endometrium. That focal tissue can shed unpredictably, producing spotting between periods, irregular or prolonged bleeding, or bleeding after menopause. Many polyps cause no symptoms and are discovered during imaging or evaluation for another concern. Most are benign. A polyp, however, cannot be labeled benign by appearance alone; histologic examination is what assesses atypia, hyperplasia, or cancer.