USG FINDINGS:

Well defined hyperechoic lesion is seen within endometrial cavity.

Lesion shows vascular pedicle on Doppler S/O polyp

An endometrial polyp is a localized overgrowth of the endometrial tissue, often detected during a pelvic ultrasound (USG). Here’s what to expect in an ultrasound report for an endometrial polyp:

Ultrasound Features of Endometrial Polyp:

1. Hyperechoic or Isoechoic Mass: The polyp appears as a well-defined, homogenous, echogenic (bright) mass within the endometrial cavity.
2. Endometrial Thickening: Focal or diffuse thickening of the endometrium may be seen.
3. Smooth Contours: Polyps usually have smooth, regular margins.
4. No Significant Posterior Shadowing: Unlike fibroids, polyps do not typically show acoustic shadowing.
5. Presence of a Feeding Vessel (Doppler USG): Color Doppler often shows a single central feeding vessel (a distinguishing feature from other lesions like fibroids).
6. Size and Number: Can range from a few millimeters to several centimeters and may be single or multiple.

Best Ultrasound Techniques for Diagnosis:

• Transvaginal Ultrasound (TVS): Offers a clearer and more detailed view of the endometrium.
• Saline Infusion Sonohysterography (SIS): Involves injecting sterile saline into the uterus to improve visualization of the polyp and differentiate it from other causes of endometrial thickening.

Differential Diagnosis:

• Endometrial hyperplasia (diffuse thickening, no focal mass).
• Submucosal fibroids (hypoechoic with shadowing, may distort the endometrium).
• Endometrial carcinoma (irregular mass with vascularity).

Management:

• Small, asymptomatic polyps may be monitored.
• Symptomatic polyps (causing abnormal bleeding or infertility) are removed via hysteroscopic polypectomy.
• Biopsy is recommended for postmenopausal women or if malignancy is suspected.