Clinicopathological spectrum of hysterectomy specimens in a tertiary care hospital- A review of 826 cases

Abstract

Introduction: Hysterectomy is one of the most common surgeries performed for common gynaecological indications, but less frequently done for tumors of female genital tract. Abnormal uterine bleeding (AUB) is one of the most common indications for hysterectomy. Histopathology is essential to confirm these common causes, but also helps to identify rare causes and to rule out malignancy. This study aims to anaylse the age pattern, clinical indications, clinicopathological correlation of hysterectomy cases along with distribution, causes and histopathological pattern of endometrial lesions in AUB. Material and Methods: The present study is a retrospective study done at Trichy SRM medical college hospital with hysterectomies done between January 2018 to November 2019 been included in the study. Clinical and Histopathological details were recorded, analysed and compared. Results: Of the 826 cases, Total abdominal hysterectomy was the most common surgery. The age varied from 21 to 85 with fourth decade as the most common age. Fibroid uterus and AUB were the most common clinical indication. Histopathology revealed leiomyoma as the most common diagnosis. About 95.5% cases correlated with clinical diagnosis. Of the 258 AUB cases, 100 had pure endometrial pathology and 31 cases showed combined endometrial and other pathologies. Totally 76 cases of endometrial hyperplasia were identified and 65 presented with AUB. About 11.6% AUB patients had malignancy and endometrial carcinomacomprised of 3.9% cases. Conclusion: Histopathological evaluation is essential to substantiate the clinical findings, identify missed pathologies, establishing a definitive etiology thereby aiding effective treatment of the pathology.

Histopathological analysis of gynaecological hysterectomy specimens at a tertiary care hospital in southern Nigeria

“…Only three cases had cystic glandular hyperplasia, which is consistent with the diagnosis of DUB, while the remaining women who underwent hysterectomy for this diagnosis had adenomyosis, endometrial polyp, secretory endometrium, or disordered proliferative endometrium. Other authors made similar observations [13,30] . Chronic cervicitis was identified as the most common pathological finding in the cervix.…”

“…The most common myometrial finding was Leiomyoma. Other researchers reported similar findings [11,13,17,18,20,27,[29][30][31] . Adenomyosis, defined as the presence of endometrial glands and stroma deep within the myometrium, is the second most common myometrial pathology in this study.…”

Histo-pathological patterns in hysterectomy specimens at a tertiary care centre in India

“…In India, hysterectomy contributes to 6% of all surgical procedures done. [ 8 ] The current study was a one-year retrospective study and represents various lesions seen histologically in hysterectomy specimens and their clinical correlation. In this study, 442 cases were included with age ranges from 18-80 years with the commonest age group between 31 - 40 years (203 cases, 45.9%), followed by 41 - 50 years (144 cases, 32.57 %).…”

retrospective study of correlation of clinical diagnosis and ultrasonographical findings with histopathological diagnosis of patients underwent hysterectomies for various indications

“…Abnormal uterine bleeding is one of the most important indications for hysterectomy. 8 It has been observed in certain areas that between 21.4% and 44.7% of the submitted samples from hysterectomy reveal no pathology after histological evaluation and for some conditions the indication will not be justified and not worth the risk. Hence the aim of the study was to find out the efficacy of clinical and USG findings in diagnosing gynecological disorders so that only valid indicated cases are taken up for hysterectomy.…”