A Comprehensive Study of Uterine Lesions in Hysterectomy Specimens: Clinical, Radiological, and Histopathological Insights

Introduction: Hysterectomy is a common surgical procedure performed worldwide to treat various benign and malignant uterine pathologies, including leiomyoma, adenomyosis, and endometrial abnormalities. This study aimed to evaluate the histopathological spectrum of uterine lesions in hysterectomy specimens and correlate clinical, radiological, and histopathological findings to determine the most common indications and pathological findings. Methodology: This retrospective and prospective observational study analyzed 300 hysterectomy specimens collected between July 2017 and December 2018. The specimens were processed using routine paraffin tissue processing methods, and sections were stained with hematoxylin and eosin. Clinical data, including age, symptoms, and radiological findings, were correlated with histopathological results. Inclusion criteria included all hysterectomy specimens, while exclusion criteria ruled out cervical, ovarian, and fallopian tube lesions, as well as poorly preserved samples. Results: The study found that the most common age group for hysterectomy was 41–50 years (43.00%). Menorrhagia (37.46%) and uterine prolapse (30.94%) were the most frequent clinical presentations. Histopathologically, the proliferative phase was the most common endometrial finding (37.46%), followed by atrophic endometrium (27.04%). Leiomyoma (43.32%) was the predominant myometrial lesion, with the intramural type (54.89%) and hyalinization (36.09%) as the most common subtype and secondary change, respectively. Adenomyosis (28.01%) was also frequently observed. Conclusion: Hysterectomy is an effective treatment for various uterine pathologies, with leiomyoma and adenomyosis being the most common histopathological findings. The study highlights the significance of histopathological examination for accurate diagnosis and management, even in grossly normal specimens. Clinical and radiological evaluations alone may not adequately diagnose conditions such as adenomyosis or early-stage malignancies.