Histopathological Analysis of Hysterectomy Specimens in a Tertiary Care Centre: A Retrospective Study

Rashmi Wankhade, Pratibha Dawande
Cureus · 2023 · vol. 15(12) , pp. e50497 · doi:10.7759/cureus.50497 · PMID:38226089 · PMC10788238 · W4389737433
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective study of 110 hysterectomy specimens identified leiomyoma as the most common myometrial lesion, proliferative phase endometrium as the most common endometrial pathology, and chronic cervicitis as the most frequent incidental finding, generally supporting preoperative diagnoses.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This hospital-based retrospective study analyzed 110 hysterectomy specimens collected in a tertiary care pathology department from February 2022 to January 2023, using gross examination and H&E-stained histopathology to determine indications, clinicopathological correlations, and lesion patterns across abdominal, vaginal, laparoscopic, and total abdominal hysterectomies (excluding obstetric hysterectomies). The most common preoperative/clinical indications were fibroid uterus, uterovaginal prolapse, and dysfunctional uterine bleeding, while the most frequent endometrial finding was proliferative phase endometrium and the most common myometrial lesion was leiomyoma; adenomyosis was identified in 23 cases, with leiomyoma and adenomyosis co-occurring in 20 cases. The authors reported that in most cases (70% to 100%), the final histopathological diagnosis supported the preoperative clinical diagnosis, and noted that lesions such as chronic cervicitis and adenomyosis were sometimes discovered incidentally. This paper is centrally about endometriosis and/or adenomyosis-related pathology in hysterectomy specimens—specifically adenomyosis detection and its occurrence among myometrial lesions.

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Abstract

Introduction The uterus is a crucial reproductive organ that is susceptible to the development of several non-neoplastic and neoplastic diseases in women, greatly increasing morbidity and mortality. Although there are various therapeutic options, hysterectomy is still a popular treatment option throughout the world. Abnormal uterine bleeding, pelvic pain, pelvic inflammatory disease (PID), prolapse of the uterus, adenomyosis, endometriosis, fibroids, gynecological malignancies, and obstetric problems that require hysterectomy, all samples must be examined histopathologically. Histopathological examination of the specimens obtained after hysterectomy is important for both diagnosis and treatment. The current work aimed to identify the various clinical indications, analyze the clinicopathological correlation in hysterectomy specimens, and analyze the patterns of lesions in hysterectomy specimens. Materials and methods This study was conducted in the Department of Pathology at the Datta Meghe Medical College, Wanadongari, Nagpur, from February 2022 to January 2023. All types of hysterectomy specimens received during this year were examined, and the tissues were processed and stained with H&E. Histopathological examination was performed, and various lesions in the hysterectomy specimens were examined. The study included all forms of hysterectomy, including abdominal, vaginal, laparoscopic, and total abdominal hysterectomy. Results An analysis of 110 cases of hysterectomy revealed that abdominal hysterectomy was the type of hysterectomy in 79 (71.82%) cases, with a maximum age range of 35 to 45 years (42.72%). The proliferative phase endometrium was the most common endometrial pathology, accounting for 43 (39.09%) cases, followed by the atrophic endometrium in 35 (31.82%) cases. Leiomyoma was the most prevalent myometrial lesion, accounting for 52 (47.28%) cases, followed by adenomyosis, accounting for 23 (20.91%) cases. Chronic cervicitis was the most common incidental finding in the hysterectomy samples, accounting for 85 (77.28%) cases. Follicular cysts, representing 22 (20%) cases, were the most common ovarian lesions, followed by serous cystadenoma in seven (6.37%) cases. Two cases of malignant tumors were noted: one case of endometrial carcinoma and one case of mucinous cystadenocarcinoma of the ovary. In most cases, ranging from 70% to 100%, the final histopathological diagnosis supports the preoperative clinical diagnosis. Conclusion Hysterectomy is the most common major gynecological surgery performed under elective conditions. Although histological studies and clinical diagnoses are closely correlated, several lesions, including chronic cervicitis and adenomyosis, were discovered incidentally. Therefore, every hysterectomy specimen must undergo a thorough histological investigation, even if it appears superficially normal, to confirm the diagnosis and improve postoperative care.

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endometriosisadenomyosis

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