Histomorphological study of lesions of corpus uteri in hysterectomy specimens: a tertiary care centre study

In: Tropical Journal of Pathology and Microbiology · 2019 · vol. 5(9) , pp. 684–691 · doi:10.17511/jopm.2019.i09.11 · W3015703951
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This study examined 450 hysterectomy specimens, finding leiomyoma to be the most common pathological diagnosis, particularly in the fifth decade, with malignant lesions showing higher clinicopathological correlation.

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This tertiary care pathology study examined the histomorphological spectrum and age-group distribution of corpus uteri lesions in 450 hysterectomy specimens collected over five years (Oct 2012–Sep 2017), with clinicopathological correlation based on histopathology results. The most common hysterectomy approach was abdominal (84%), with peak incidence in the 5th decade, and the most frequent preoperative clinical diagnosis and final pathological diagnosis were fibroid uterus and leiomyoma, respectively, while endometrial carcinoma accounted for 2.67% of malignancies. Clinicopathological correlation was reported in 46% of cases, higher among malignant lesions (87.5%) than benign lesions (65.16%), with the authors emphasizing mandatory histomorphological evaluation given diagnostic and therapeutic implications. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background: Hysterectomy is the most common surgery performed in gynaecological practice, sometimes considered a lifesaving procedure in women, which also improves the quality of life for women with certain uterine pathologies such as fibroids, endometriosis, uterine prolapse and various types of cancer. The diagnostic value of histopathological examination is well explained and enables determination of origin of a particular benign or malignant lesion and in the latter, where adjuvant treatment is dependent upon grade and extent of invasion of disease. Aims: To study the histomorphological spectrum of lesions of corpus uteri in hysterectomy specimens and their distribution in different age groups along with clinicopathological correlation. Materials and Methods: The present study comprised of 450 hysterectomy specimens with lesions in the corpus uteri, received in the Department of Pathology, Navodaya Medical College, Raichur, during 5 years from October 2012 to September 2017. All the specimens were subjected to histomorphological study and clinical correlation was made. Results: The commonest type of hysterectomy was abdominal hysterectomy (84%) with the peak age incidence in 5th decade (45.33%). Most common clinical diagnosis was fibroid uterus (45.55%) and pathological diagnosis was leiomyoma (59.33%) and malignancy being endometrial carcinoma (2.67%). Clinicopathological correlation was observed in 46% of cases, commonly among malignant lesions (87.5%), when compared to benign lesions of corpus uteri (65.16%). Conclusion: The study emphasizes on histomorphological evaluation of lesions in hysterectomy specimens and is mandatory as various benign and malignant conditions occur with increasing frequency and carries diagnostic and therapeutic significance and should be done in all cases for confirming the preoperative clinical diagnosis and thus ensuring a better postoperative outcome.
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Background

Hysterectomy is the most common surgery performed in gynaecological practice, sometimes considered a lifesaving procedure in women, which also improves the quality of life for women with certain uterine pathologies such as fibroids, endometriosis, uterine prolapse and various types of cancer. The diagnostic value of histopathological examination is well explained and enables determination of origin of a particular benign or malignant lesion and in the latter, where adjuvant treatment is dependent upon grade and extent of invasion of disease. Aims: To study the histomorphological spectrum of lesions of corpus uteri in hysterectomy specimens and their distribution in different age groups along with clinicopathological correlation. Materials and Methods: The present study comprised of 450 hysterectomy specimens with lesions in the corpus uteri, received in the Department of Pathology, Navodaya Medical College, Raichur, during 5 years from October 2012 to September 2017. All the specimens were subjected to histomorphological study and clinical correlation was made.

Results

The commonest type of hysterectomy was abdominal hysterectomy (84%) with the peak age incidence in 5th decade (45.33%). Most common clinical diagnosis was fibroid uterus (45.55%) and pathological diagnosis was leiomyoma (59.33%) and malignancy being endometrial carcinoma (2.67%). Clinicopathological correlation was observed in 46% of cases, commonly among malignant lesions (87.5%), when compared to benign lesions of corpus uteri (65.16%).

Conclusion

The study emphasizes on histomorphological evaluation of lesions in hysterectomy specimens and is mandatory as various benign and malignant conditions occur with increasing frequency and carries diagnostic and therapeutic significance and should be done in all cases for confirming the preoperative clinical diagnosis and thus ensuring a better postoperative outcome. Downloads

References

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