Frequency and morphology of benign histopathological lesions in total abdominal hysterectomy specimens.

Abstract

Hysterectomy is one of the most frequently performed gynecological procedure all over the globe undertaken for varying indications, to effectively cure many gynaecological conditions. Histopathological analysis of the hysterectomy specimens should be undertaken for justification of procedure and diagnostic purposes. Objectives: To determine the frequency and morphology of different benign histopathological lesions in total abdominal hysterectomy specimens. Study Design: Descriptive cross-sectional study. Setting: Department of Pathology Fatima Jinnah Medical College. Period: From Jan 2015 to June 2015. Material & Methods: The gross and histopathological findings of uterus and cervix in one hundred Total Abdominal hysterectomy specimens were studied. Non-probability, purposive sampling was done. Total abdominal hysterectomy specimens with or without salpingoophorectomy of patients aged between 20 to 70 years were included. While Total abdominal hysterectomy done in mentally retarded patients and for malignancies were excluded. Patient’s data, presenting complaints and preoperative diagnosis was recorded on predesigned proforma. SPSS version 17 was used as an analytical tool. Results: Age of the patients ranged from 30-55 years with 72% between 41-50 years. The microscopic examination of the cervix revealed features of chronic cervicitis in 75% cases. The commonest neoplastic lesion was leiomyoma present in 66% of cases. Myometrium revealed foci of adenomyosis in 21% cases. Endometrial histology showed hyperplasia in 25% of cases(simple hyperplasia 20%, cystic hyperplasia 4% and complex hyperplasia 1%), hormonal imbalance in 21%, pressure atrophy in 11%, atrophic endometrium in 6% , cystic atrophy in 2% while acute and chronic endometritis in 1% and 2% of cases respectively. Conclusion: The commonest cervical lesion was chronic cervicitis (75%). The commonest benign neoplastic lesion was leiomyoma, present in 66% of cases. Other common pathologies on histology were hyperplasia in 25% of cases, adenomyosis and hormonal imbalance in 21 % of cases each, pressure atrophy in 11%, atrophic endometrium in 6% while endometritis (acute & chronic ) in 3% of cases mainly. Histopathological examination of hysterectomy specimens helps to detect the exact cause and underlined pathology.

Hysterectomies: An Audit at A Tertiary Care Public Sector Hospital in Lahore, Pakistan

“…The present study showed that the most common histopathological diagnosis in uterine corpus samples was leiomyoma (40%), followed by adenomyosis (11%). One previous study from Pakistan reported similar results showing leiomyoma 66% of cases and adenomyosis 21% of cases 20 In a study conducted at Karachi, leiomyoma was 33%, adenomyosis was 23% and combined leiomyoma with adenomyosis was 23. 16 Similar results were shown in studies conducted in Lahore, Tanzania, India, United States and Nepal.…”

Histopathological Account of Obstetrical and Gynecological Specimens: Retrospective Study at a Tertiary Care Center of Peshawar

“…The majority of the samples sent for histopathology in our study were from the age group of 31-50 years (71.6%). This range is quite typical for gynecological problems that result in sampling, particularly around the late forties, as observed in several of the other studies referenced [ 3 , 4 , 7 , 8 ]. This is probably due to this being the peak reproductive age and females are more likely to present to a primary physician as compared to other age groups.…”

“…Out of 458 uterine samples in our study 24.2% were diagnosed as leiomyoma, followed by 18.8% being adenomyoma. These findings are mirrored by studies conducted in Lahore and Karachi, the highest proportion of diagnosis being leiomyoma in uterine samples, 69% and 66%, respectively [4,7]. The latter also had adenomyosis as the second most common finding at 21%.…”

“…Chronic cervicitis was present in 92.4% of the cervical samples in our setting. It is found to be the most common pathology reported on histopathology of the cervix in several studies [ 3 , 4 , 7 ]. Histopathology is therefore a vital investigation for the diagnosis of common cervical disease, including cervicitis and cervical cancer.…”

“…It is also a useful tool for the diagnosis of exclusion in dysfunctional uterine bleeding. Hysterectomy is a commonly performed surgical procedure that aids in the sampling and diagnosis of various benign and malignant diseases of the female reproductive system [ 4 ]. Cervical cancer is another entity diagnosed with histopathology and it is the second most common gynecological malignancy worldwide and the third most common cause of mortality in women worldwide [ 5 ].…”