Expanded Study on Patterns of Myometrial Lesions in Hysterectomy Specimens: A Retrospective Study of 520 Specimens

Introduction: Hysterectomy is the second most frequently performed major surgical procedure on women worldwide, peri and post-menopausal. In India, it accounts for only 6% of the major surgeries. Aims and objectives: To study the profile of different myometrial lesions in the 520 hysterectomy specimens received in the Department of Pathology, GMC Jammu, for histopathological studies. Material and methods: The study was retrospective in nature. The study material comprised 520 hysterectomy specimens for a period of one year. They were labelled correctly, numbered with complete clinical details and then subjected to gross and detailed histopathological examination. Results: In the present study, the mean age of the cases was 46.9 years. 49.62% undergoing hysterectomy was in the age group of 41-50 years. The most common clinical indication for hysterectomy was menorrhagia in 42.75% of cases, followed by uterovaginal prolapse in 26.6%, fibroid uterus in 20.24% of cases and other less common indications. Myometrium was grossly unremarkable in most subjects, i.e. 55.77 %. The most common lesion in the myometrium was a fibroid, i.e., 41.73% of cases. On microscopic examination, in most cases, i.e., 263 (49.77%), myometrium was within normal limits histologically. Leiomyomata were found to be commonest, i.e., 180(34.2%) followed by adenomyosis 36 (6.92%) and leiomyoma with adenomyosis 32 (6.08%) cases. Post-partum changes were seen in the myometrium in 6 (1.14%) cases. Conclusion: Histopathological examination is the gold standard for giving the final diagnosis, planning further management and ensuring the best post-operative management of the patient. Keywords: Fibroid, Hysterectomy, Myometrium