Clinico pathological study of hysterecomy for benign conditions of the uterus

Sucheta KL, Madhu Kp, Mallikarjuna Manangi, Arun BJ, Niranjan Nagaraj
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2016 · pp. 2109–2112 · doi:10.18203/2320-1770.ijrcog20161875 · W2411306589
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This retrospective study of 200 benign hysterectomy cases found that adenomyosis was present in 20% of specimens, alongside leiomyoma and chronic cervicitis, highlighting the importance of histopathological examination regardless of preoperative diagnosis.

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This retrospective study evaluated the correlation between preoperative diagnoses and final histopathological findings in 200 hysterectomy specimens removed for benign uterine conditions at two hospitals in Bangalore, India, from 2012 to 2014. Specimens were formalin-fixed, paraffin-embedded, sectioned, stained with hematoxylin and eosin, and analyzed statistically; leiomyoma was identified in 31%, adenomyosis in 20%, chronic cervicitis in 51%, endometritis in 3%, and no pathology in 10% of specimens. The authors concluded that all hysterectomy specimens should undergo histopathological examination regardless of the preoperative endometrial diagnosis; no major study limitation was reported. Relevance to adenomyosis: adenomyosis was identified histopathologically in 20% of the benign hysterectomy specimens, though the paper’s main focus is clinicopathological correlation across benign uterine conditions.

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Abstract

Background: Uterus, being a vital female reproductive organ is subjected to many different pathological conditions. The objective was to study the correlation between the preoperative clinical diagnosis and the final histopathology of hysterectomy specimens.Methods: This is a retrospective study by the authors of all cases who underwent a hysterectomy over a 2 year period (2012-2014). All hysterectomies performed for malignant indication were excluded. The specimen was sent for histopathology examination to the pathology department of Vanivilas Hospital and Bowring and Lady Curzon Hospital, Bangalore, India. All hysterectomy specimens were fixed in 10% buffered formalin, paraffin embedded and 4-5μm thick sections were cut and stained with haematoxylin and eosin. All the collected data was tabulated and stastically analyzed by using SPSS software.Results: During the 2 year study period there were a total of 200 cases eligible for analysis. Leiomyoma was reported in 31% of specimen. Adenomyosis was reported in 20% of present cases. Chronic cervicitis was observed in 51% of cases in present study. Endometritis was observed in 3% of cases in present study. Tubercular endometritis was observed in 0.5% of cases. Endometrial polyp was observed in 1% of case in this study. 10% of the specimen was unremarkable and no pathology could be found.Conclusions: All hysterectomy specimens should be sent for histopathology regardless of the preoperative histopathology of the endometrium.
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Background

Uterus, being a vital female reproductive organ is subjected to many different pathological conditions. The objective was to study the correlation between the preoperative clinical diagnosis and the final histopathology of hysterectomy specimens.

Methods

This is a retrospective study by the authors of all cases who underwent a hysterectomy over a 2 year period (2012-2014). All hysterectomies performed for malignant indication were excluded. The specimen was sent for histopathology examination to the pathology department of Vanivilas Hospital and Bowring and Lady Curzon Hospital, Bangalore, India. All hysterectomy specimens were fixed in 10% buffered formalin, paraffin embedded and 4-5μm thick sections were cut and stained with haematoxylin and eosin. All the collected data was tabulated and stastically analyzed by using SPSS software.

Results

During the 2 year study period there were a total of 200 cases eligible for analysis. Leiomyoma was reported in 31% of specimen. Adenomyosis was reported in 20% of present cases. Chronic cervicitis was observed in 51% of cases in present study. Endometritis was observed in 3% of cases in present study. Tubercular endometritis was observed in 0.5% of cases. Endometrial polyp was observed in 1% of case in this study. 10% of the specimen was unremarkable and no pathology could be found.

Conclusions

All hysterectomy specimens should be sent for histopathology regardless of the preoperative histopathology of the endometrium. Metrics

References

Karthikeyan TM, Veenaa N, Kumar AC, Thomas E. Clinicopathological study of hysterectomy among rural patients in a tertiary care center. J Dental Med Sci. 2015;14(5):25-7. Dickers RC, Greenspan JR, Strauss L. Histology and clinical correlation of fibroid uterus. Am J Obst Gyn. 1982;144:841. Sutherland, Bruce. Fibroid uterus. Shaws Text book of Gynae. 9th edition, Elsevier;1971:453. Nayak SR, Vaidhya PR, Thaker SS. Clinic histopathological changes of hysterectomy patients. J Obst Gyn. 1976;26:585. Sagar S. Histopathological cases of uterus. J Obst Gynae. 1980;30:165. Daniel M, Emil F cava, Paul S. Indication of hysterectomy and its complications. Am J Obst Gyn. 1982;136:322. Pend S. Hysterectomy and its complications. J Obst Gyn. 1975;25:400. Kasturilal K, Gupta Y. Clinical profile and histopathology correlation of hysterectomy patients. J Obst Gyn. 1981;31:773. Barr W, Charteris AA. Clinical outcome of dysfunctional uterine bleeding. J Obst Gynae. 1955;62:195. Pandya S, Shat AB. Prevalence of adenomyesis and its outcome. J Obst Gyn. 1987;37:255. Reddy DB, Raju GC, Suvarnakumari G. Mode of delivery after obstetric anal sphincter injury and the risk of long-term anal incontinence. J Obst Gyn. 1975;25:791. Takar U, Fernandes. Histology of ovarian tumours. J Obst Gyn. 1964;14:811. Emil F Cava. Case reports histopathological changes of adenomysis. Am J Obst and Gyn. 1975;122:434.

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