{"paper_id":"020c385a-04a7-46ea-b2d1-c6d475d1894c","body_text":"~ 205 ~ \nInternational Journal of Clinical and Diagnostic Pathology 2019; 2(2): 205-207 \n \nISSN (P): 2617-7226 \nISSN (E): 2617-7234 \nwww.patholjournal.com \n2019; 2(2): 205-207 \nReceived: 05-05-2019 \nAccepted: 09-06-2019 \n \nDr. Amrish Kumar \nAssociate Professor \nDepartment of Pathology, \nAutonomous State Medical \nCollege, Shahjahanpur, \nUttar \nPradesh, India \n \nDr. Anima Prasad \nProfessor & Head (Department \nof Obs & Gynae), Hind \nInstitute Of Medical Sciences, \nSitapur, \nUttar Pradesh, India \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCorresponding Author: \nDr. Amrish Kumar \nAssociate Professor \nDepartment of Pathology, \nAutonomous State Medical \nCollege, Shahjahanpur, \nUttar \nPradesh, India \n \nHistopathological analysis of hysterectomy at a \ntertiary care hospital \n \nDr. Amrish Kumar and Dr. Anima Prasad \n \nDOI: https://doi.org/10.33545/pathol.2019.v2.i2d.105 \n \nAbstract \nBackground: The present study was conducted to assess histopathology of hysterectomy specimens. \nMaterials & Methods: The present study was conducted on 72 hysterectomy specimens. The \nhistopathological findings of uterus and cervix were then noted \nResults: Age group 21-30 years had 8, 31-40 years had 10, 41-50 years had 45, 51-60 years had 5 and \n61-70 years had 4. The difference was significant (P< 0.05). Co mmon clinical indications were ovarian \ncyst in 2, menorrhagia in 25, fibroid uterus in 20, chronic cervicitis in 4 , carcinoma cervix in 6, \ncarcinoma endometrium in 2, dermoid cyst in 7 and uterine polyp in  6. The difference was significant \n(P< 0.05). Histopathology was leiomyoma in 5, adenomyosis in 12, chronic cervicitis in 16, SCC in 10, \nadenocarcinoma in 5, endocervical polyp in 4 and normal histology  in 20. The difference was \nsignificant (P< 0.05). \nConclusion: Authors found that histopathology was leiomyoma, adenomyosis, chronic cervicitis, SCC, \nadenocarcinoma, endocervical polyp and normal histology. \n \nKeywords: Adenomyosis, endocervical polyp, hysterectomy \n \nIntroduction  \nThe female genital tract includes the uterine corpus and cervix, the uterine co rpus consists of \nendometrium and myometrium. Uterus, a vital reproductive organ is subj ected to many \nbenign and malignant pathologies [1]. The uterine corpus under hormonal influence is, \ndenuded monthly of its endometrial mucosa. The lesions of the uterine co rpus and cervix \naccount for most patient visits to gynecologists. Many treatment are av ailable nowadays \nincluding medical and conservative surgical procedures but hysterectomy rem ains the most \npreferred method to manage gynaecological disorders [2]. \nMost common complaints presented are per vaginal bleeding, vaginal dischar ge, pain \nabdomen, irregular menstruation, postmenopausal bleeding, mass per abd omen, something \ncoming out of vagina etc. Many treatment options are available including medical and \nconservative surgical treatments but hysterectomy remains one of the mo st preferred method \nto manage gynecological disorders. It should be performed when the r isk of preserving the \nuterus is greater than it's removal or when the disabling symptoms  for which there is no \nsuccessful medical treatment [3]. \nIt is not risk free adhesions formation. Majority (90%) of hysterecto mies are performed for \nbenign diseases. Alternate like endometrial ablation, intrauterine hormonal dev ices like \nMirena must be considered to avoid hysterectomies for benign diseases. Histo-p athological \nexamination of hysterectomy specimens carries both diagnostic and therapeu tic significance. \nIt is associated with risk of iatrogenic premature menopause, surgical and an esthetic \ncomplications like fistula involving ureter, bladder and gut and also chronic ab dominal pain \n[4]. The present study was conducted to assess histopathology of hysterectomy sp ecimens.  \n \nMaterials & Methods \nThe present study comprised of 72 hysterectomy specimens.  \nThe hysterectomy specimens received were immediately transferred into 10 % fresh formalin. \nAfter 24 hours fixation, the specimen was examined grossly an d necessary sections were \nobtained from uterus that includes endometrium, myometrium, ectocervix and endocervix. \nAdditional bits were taken depending on the pathology present. The histopatho logical \nfindings of uterus and cervix were then noted. \n\n\nInternational Journal of Clinical and Diagnostic Pathology  http://www.patholjournal.com \n \n~ 206 ~ \nResults thus obtained were subjected to statistical analysis. P \nvalue less than 0.05 was considered significant. \n \nResults \n \nGraph 1: Age distribution of all hysterectomies \n \nAge group (Years) Number P value \n21-30 8 \n0.04 \n31-40 10 \n41-50 45 \n51-60 5 \n61-70 4 \n \nTable I, graph I shows that age group 21-30 years had 8, 31-\n40 years had 10, 41-50 years had 45, 51-60 years had 5 and  \n61-70 years had 4. The difference was significant (P< 0.05). \n \n \n \nGraph 1: Age distribution of all hysterectomies \n \nTable 2: Clinical Indications of Hysterectomy \n \nIndication Number P value \nOvarian cyst 2 \n0.01 \nMenorrhagia 25 \nFibroid uterus 20 \nChronic cervicitis 4 \nCarcinoma cervix 6 \nCarcinoma endometrium 2 \nDermoid cyst 7 \nUterine polyp 6 \n \nTable II, graph II shows that common clinical indications \nwere ovarian cyst in 2, menorrhagia in 25, fibroid uterus in \n20, chronic cervicitis in 4, carcinoma cervix in 6, carcinoma \nendometrium in 2, dermoid cyst in 7 and uterine polyp in 6. \nThe difference was significant (P< 0.05). \n \n \n \nGraph 2: Clinical Indications of Hysterectomy \n \nTable 3: Histopathological diagnosis \n \nIndication Number P value \nLeiomyoma 5 \n0.01 \nAdenomyosis 12 \nChronic cervicitis 16 \nSCC 10 \nAdenocarcinoma 5 \nEndocervical polyp 4 \nNormal histology 20 \n \nTable III, graph III shows that histopathology was \nleiomyoma in 5, adenomyosis in 12, chronic cervicitis in 16, \nSCC in 10, adenocarcinoma in 5, endocervical polyp in 4 \nand normal histology in 20. The difference was significant \n(P< 0.05). \n \n \n \nGraph 3: Histopathological diagnosis \n \nDiscussion \nHysterectomy is the most commonly performed surgery in \ngynaecological practice as it provides definitive cure and \naccurate diagnosis [5]. The clinical indications to perform \nthis major surgery should always be justified as it has its \nown psychological, emotional, medical, hormonal and \nsexual effects on a females life. Hysterectomy is the most \ncommonly performed major gynaecological surgery \nthroughout the world. It is a successful operation in terms of \nsymptom relief and patient satisfaction and provides \ndefinitive cure to many diseases involving uterus as well as \nadnexae [6]. The present study was conducted to assess \nhistopathology of hysterectomy specimens. \nIn this study, age group 21-30 years had 8, 31-40 years had \n10, 41-50 years had 45, 51-60 years had 5 and 61-70 year s \nhad 4. Jandial et al . [7] conducted a study to evaluate the \nwide range of pathological lesions, commonest pathology \ninvolved and correlation of the preoperative clinical \ndiagnosis with the histopathological diagnosis in the \nhysterectomy specimens. The most common type of \nhysterectomy was total abdominal hysterectomy with \nbilateral salpingo-ophorectomy with 102 cases (63.7%). \nPeak incidence at 5th decade of life in 92 cases (57.5%) was \nnoted. The most common clinical indication was fibroid \nuterus in 81 cases (50.6%). Proliferative phase of \nendometrium was the commonest finding in 87 cases \n(54.3%). In case of myometrium, 95 leiomyomas were \nnoted. On histomorphological study of cervical lesions, \nchronic cervicitis was commonest finding in 75 (46.8%) \ncases. \nWe found that common clinical indications were ovarian \ncyst in 2, menorrhagia in 25, fibroid uterus in 20, chronic \ncervicitis in 4, carcinoma cervix in 6, carcinoma \n\nInternational Journal of Clinical and Diagnostic Pathology  http://www.patholjournal.com \n \n~ 207 ~ \nendometrium in 2, dermoid cyst in 7 and uterine polyp in 6. \nShakira et al . [8] conducted a study to study the \nhistopathological features of varied uterine lesions, their \nprofile and distribution of different lesions in relation of age. \nA total of 3576 histopathology samples were received in this \nperiod. There were 1173 gynaecology samples during this \nperiod out of which 22% (261 cases) were that of \nhysterectomy. Histopathology diagnosis showed \nLeiomyoma in 48.6% (127 cases), Adenomyosis was seen in \n10.3% (27 cases), Endometrioid Adenocarcinoma was seen \nin 1.14% (3 cases). \nWe observed that histopathology was leiomyoma in 5, \nadenomyosis in 12, chronic cervicitis in 16, SCC in 10, \nadenocarcinoma in 5, endocervical polyp in 4 and normal \nhistology in 20. A et al. [9] found that Menorrhagia, fibroid \nuterus and uterovaginal prolapse were the most common \nclinical indications for hysterectomy. The most common \npathologies identified were atrophic endometrium in \nendometrium, leiomyoma in myometrium, chronic cervicitis \nin cervix, ovarian cysts in ovaries and salpingitis in fallopian \ntubes. The pathologic examination confirmed the clinical \ndiagnosis in majority of the cases. Khunte [10] reported a \nhigher incidence of atrophic endometrium i.e. 26.53% in \ntheir study. Endometrial hyperplasia constituted the second \nmost common endometrial pathology. \n \nConclusion \nAuthors found that histopathology was leiomyoma, \nadenomyosis, chronic cervicitis, SCC, adenocarcinoma, \nendocervical polyp and normal histology. \n \nReferences \n1. Watts WF, Kimbrough RA. Hysterectomy Analysis of \n1000 consecutive operations. Obstet Gynecol 1956; \n7(5):483-93.  \n2. Sarfraz T, Tariq H. Histopathological findings in \nmenorrhagia: A study of 100 hysterectomy specimens \nPak J Pathol. 2005; 16(3):83-5. \n3. Dicker RC, Seally MJ, Greenspan JR. Hysterectomy \namong women of reproductive age trends in United \nStates JAMA 1990; 248:328-35. \n4. Ajmera SK, Mettler L, Jonat W. Operative spectrum of \nhysterectomy in a German University hospital, a \nretrospective analysis, J Obstet Gynaecol India. 2006; \n56(1):59-63.  \n5. Domblae V, Gundalli S. Histopathological analysis of \nuterine lesions in hysterectomy specimens. Int J Sci \nRes. ISSN (Online): 2319-7064.  \n6. Archana B, Michelle F. Evaluation and \nhistopathological correlation of abnormal uterine \nbleeding in perimenopausal women Bombay Hospital J. \n2010; 52(1):69-72. \n7. Jandial R, Choudhary M, Singh K. Histopathological \nanalysis of hysterectomy specimens in a tertiary care \ncentre: study of 160 cases, Int Surg J. 2019; 6:2856-9. \n8. Shakira P, Subhana T. A clinicopathological review of \nelective abdominal hysterectomy J Surg Pakistan. 2008; \n13(1):26-9.  \n9. Sobande AA, Eskander M, Archibong EI, Damole IO. \nElective hysterectomy: A clinicopathological review \nfrom Abha catchment area of Saudi Arabia WAJM \n2005; 24(1):31-5.  \n10. Khunte VP. Spectrum of Lesions in Hysterectomy \nspecimens J Cont Med A Dent. 2017; 5(3):29.","source_license":"CC0","license_restricted":false}