Study of endometrial and cervical histopathology in adenomyosis

Anandakumari Matangi, Alpha Manukonda, Abhizna Bommiti
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2020 · vol. 9(5) , pp. 1779 · doi:10.18203/2320-1770.ijrcog20201488 · W3013925488
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This retrospective study analyzed histopathological changes in endometrium and cervix of 100 hysterectomy specimens, finding that adenomyosis is a leading cause of abnormal uterine bleeding often associated with atrophic endometrium and chronic cervicitis.

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This retrospective study analyzed histopathological changes in the endometrium and cervix of 100 women who underwent hysterectomy for adenomyosis. The researchers found that atrophic endometrium and chronic cervicitis were prevalent findings, with inflammatory changes also commonly observed in Pap smears among these patients. The paper identifies adenomyosis as a leading cause of abnormal uterine bleeding and a frequent indication for hysterectomy when medical therapy fails. This paper is centrally about adenomyosis — specifically examining the associated histopathological features of the endometrium and cervix in hysterectomy specimens.

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Abstract

Background: Hysterectomy is the most common gynaecological surgery performed in the perimenopausal and post-menopausal women all over the world. One of the most common cause of AUB is Adenomyosis based on histopathological evidence and the ultimate mainstay stay of treatment is hysterectomy in those patients not responding to medical therapy. Endocervical and Endometrial histopathology in adenomyosis are studied in this study. Objective of this study was to analyses various histopathological changes of endometrium and cervix in hysterectomy specimens showing features of adenomyosis.Methods: This is a retrospective study conducted at Government Victoria Hospital for Women and Children, Visakhapatnam, Andhra Medical College for a period of one year from January 2019 to December 2019.100 cases with histopathology reports of hysterectomy specimens showing changes suggestive of adenomyosis were studied for 1 year. Those cases which showed features of adenomyosis were taken and the preoperative details and procedures done on the patient were retrieved and endometrial and cervical biopsy, Pap Smear changes of these patients were studied.Results: Out of 100 cases, 37 members (majority) showed features of atrophic endometrium, 69 members (majority) showed features of chronic cervicitis, about 58 members (majority) showed inflammatory changes in Pap Smear. In the 100 cases, 75 cases are in perimenopausal age group i.e., 40-50 years, 80 of them are multiparous women, 85 members had mild to moderate degree of anaemia while only about 15 members had severe anemia. Adenomyosis was found to be the leading cause of AUB.Conclusions: Adenomyosis is one the leading causes of AUB and hence also an important cause of hysterectomy in those with failed medical therapy. Histopathological changes of endometrium and cervix are analyzed from D and C and Pap Smear reports of patients whose specimens are confirmed to be having adenomyosis.
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Background

Hysterectomy is the most common gynaecological surgery performed in the perimenopausal and post-menopausal women all over the world. One of the most common cause of AUB is Adenomyosis based on histopathological evidence and the ultimate mainstay stay of treatment is hysterectomy in those patients not responding to medical therapy. Endocervical and Endometrial histopathology in adenomyosis are studied in this study. Objective of this study was to analyses various histopathological changes of endometrium and cervix in hysterectomy specimens showing features of adenomyosis.

Methods

This is a retrospective study conducted at Government Victoria Hospital for Women and Children, Visakhapatnam, Andhra Medical College for a period of one year from January 2019 to December 2019.100 cases with histopathology reports of hysterectomy specimens showing changes suggestive of adenomyosis were studied for 1 year. Those cases which showed features of adenomyosis were taken and the preoperative details and procedures done on the patient were retrieved and endometrial and cervical biopsy, Pap Smear changes of these patients were studied.

Results

Out of 100 cases, 37 members (majority) showed features of atrophic endometrium, 69 members (majority) showed features of chronic cervicitis, about 58 members (majority) showed inflammatory changes in Pap Smear. In the 100 cases, 75 cases are in perimenopausal age group i.e., 40-50 years, 80 of them are multiparous women, 85 members had mild to moderate degree of anaemia while only about 15 members had severe anemia. Adenomyosis was found to be the leading cause of AUB.

Conclusions

Adenomyosis is one the leading causes of AUB and hence also an important cause of hysterectomy in those with failed medical therapy. Histopathological changes of endometrium and cervix are analyzed from D and C and Pap Smear reports of patients whose specimens are confirmed to be having adenomyosis. Metrics

References

Konar H, Duttas DC. Textbook of gynecology, 7th edition, Jaypee publishers pvt. limited, New Delhi, India, Chapter no. 22; 2016:257-259. Padubidri VG, Daftary SN. Howkins and Borne SHAWS textbook of gynecology 16th edition, Reed Elsevier India Private Limited, New Delhi, India, chapter no.30; 2015:418-423. Berek JS. and Novaks. Gynecology 14th edition, Lippincott Williams and Wilkins, New York, London, chapter no.29; 2014:1128-1131. Bhosle A, Fonseca M. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. Bombay Hosp J. 2019;52:69-72. Benagiano G, Brosens I. History of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20:449-63. Renner SP, Lermann J, Hackl J, Burghaus S, Oppelt P, Binder H, et al. Chronische Erkrankung. Endometriose. Geburtshilfe and Frauenheilkunde. 2012;72(10):914-9.

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adenomyosis

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