The pathology of hysterectomy specimens following trans‐cervical resection of the endometrium

Thomas A. McCulloch, T A McCulloch, Bart Wagner, B Wagner, S Duffy, Sean Duffy, S Barik, John H. Smith, J H Smith
Histopathology · 1995 · vol. 27(6) , pp. 541–547 · doi:10.1111/j.1365-2559.1995.tb00325.x · PMID:8838334 · W2060743188
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This study examined 29 hysterectomy specimens after endometrial resection, finding residual endometrium in most, including inactive endometrium resembling Asherman's syndrome, along with adenomyosis, hyperplasia, haematocolpos, and pigment deposits from surgical instruments.

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Abstract

The pathological findings in 29 hysterectomy specimens from a series of 175 patients undergoing trans-cervical resection of the endometrium are presented. In all but one case endometrium was present. Although all phases of the normal menstrual cycle were represented, in nine (28%) cases the endometrium appeared inactive, sometimes showing appearances similar to those in Asherman's syndrome. Adenomyosis was present in five (17%) cases and simple hyperplasia in one case. Haematocolpos was present in two cases. Inflammation was uncommon, usually mild in degree and present in the superficial myometrium. Four (14%) cases contained epithelioid or foreign body granulomas in the superficial myometrium. Deposits of haemosiderin and amorphous brown and/or particulate black pigment were seen in a total of 20 (69%) cases. A combination of transmission electronmicroscopy and energy dispersive analysis of X-rays showed these pigments to be a combination of charred organic material and metals, the latter corresponding to the composition of the diathermy cutting loop and electrocautery rollerball used in the ablative surgery.

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Condition tags

adenomyosis

MeSH descriptors

Cervix Uteri Cervix Uteri Endometrium Endometrium Adult Cervix Uteri Endometrium Female Granuloma Granuloma Hemosiderin Hemosiderin Humans Hysterectomy Macrophages Macrophages Metals Microscopy, Electron Middle Aged Pigmentation

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