Abnormally thickened endometrium: differential diagnosis

Abnormally thickened endometrium on imaging may occur for a number of reasons which may be categorised by whether or not they are related to pregnancy. Aetiologies may also be classified by whether the patient is premenopausal or postmenopausal.

Differential diagnosis

Pregnancy related
Non-pregnancy related

Practical points

  • endometrial thickness in the secretory phase (days 14-28) may normally be up to 12-16 mm (see: endometrial thickness)
    • nonemergent ultrasounds are optimally evaluated at day 5-10 of the menstrual cycle to reduce the wide variation in endometrial thickness
  • the thickest portion of the endometrium should be measured
  • if there is fluid in the uterine cavity, it should be excluded from the measurement, which would be the sum of the two sagittal plane thicknesses
  • ~10% of endometrial carcinoma occurs in premenopausal women

See also

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