Clinico-Pathological Assessment Of Hysterectomies In Zaria

Aim: To assess and compare accuracy of the clinical indications and histopathological diagnoses from hysterectomy specimens in Zaria. Methods: All hysterectomy specimens received in the department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria from January 1995 to December 2005 were analyzed. The speci-mens were fixed in formalin, processed in paraffin wax and his-tology slides stained with haematoxylin and eosin were studied. Frequency of clinical indications were compiled and compared with histopathological diagnoses. Results: 317 hysterectomies were analyzed. Of these 288 (90.9%) were associated with salpingo-oophrectomies. Median age of pa-tients′ was 45 years and mean age was 44.6 years. Parity of the women ranged from 0-11 with an average of 4. The clinical indications comprised non-neoplastic- 47 (14.8%) and neoplastic-226 (71.3%) causes. The commonest benign neoplastic indication was uterine fibroid 196 (61.8%). Malignant neoplastic in-dication included cervical cancer 12 (3.8%) and endometrial cancer 6 (1.9%). Cervical intraepithelial neoplasia (CIN), a preneoplastic lesion accounted for 44 (13.9%). Histopathological diagnosis of leiomyoma was made in 218 (68.8%), cervical cancer -20 (6.3%) and CIN- 49 (15.5%). Incidental pathologies seen included chronic cervi-citis -24, adenomyosis- 13 and cystadenoma - 8. Clinical indications in 14 (4.4%) patients were at variance with histological diagnosis. Conclusion: The clinical indication for hysterectomy and histo-pathological outcome are comparable in over 90% of cases. The commonest indication and histological finding in our setting is leiomyoma.