Adenomyosis: correlating clinical suspicion with histopathological diagnosis in a retrospective study

Kamal Preet, Ripan Bala, Madhu Nagpal, Harleen Kaur
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2019 · vol. 8(12) , pp. 4674 · doi:10.18203/2320-1770.ijrcog20195206 · W2989045329
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This study retrospectively analyzed 100 hysterectomy specimens for abnormal uterine bleeding, finding leiomyoma in 42% and adenomyosis in 22%, confirming the reliance on histopathological examination for definitive diagnosis.

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This retrospective study evaluated how well clinical assessment of abnormal uterine bleeding (AUB) that led to hysterectomy specimens aligned with histopathological examination (HPE) findings, focusing on adenomyosis and leiomyoma among women with AUB not responding to conservative treatment. Among 100 hysterectomy cases, leiomyoma was present in 42% and adenomyosis in 22%, with the most frequent combination being leiomyoma plus adenomyosis (26%); additional findings included chronic cervicitis and ovarian cyst in 9%, and endometrial malignancy in one case. The authors conclude that although adenomyosis and leiomyoma are often clinically suspected, confirmation relies on HPE. This paper is centrally about endometriosis and/or adenomyosis — it directly examines adenomyosis confirmation from hysterectomy specimens in relation to AUB clinical suspicion.

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Abstract

Background: Adenomyosis and leiomyoma are the common causes of abnormal uterine bleeding (AUB). In this study it is aimed to evaluate the correlation of clinical and histopathological examination (HPE) of these entities leading to abnormal uterine bleeding.Methods: This retrospective study was carried out on hysterectomy specimens of subjects who presented themselves in the department of obstetrics and gynaecology of Sri Guru Ram Das Institute of medical sciences and research, Amritsar with chief complaints of AUB not responding to conservative treatment.Results: A total of 100 women with clinical diagnosis of AUB in which hysterectomies were performed, leiomyoma was found in 42% cases, adenomyosis in 22% cases. The most frequent combination of diagnosis was leiomyoma and adenomyosis i.e. 26%. In 9% cases chronic cervicitis and ovarian cyst were detected. In one case endometrial malignancy was found.Conclusions: Though adenomyosis and leiomyoma are clinically diagnosed along with other pathological conditions of the reproductive organs but their confirmation is still to be relied upon HPE; a most important investigation.
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Background

Adenomyosis and leiomyoma are the common causes of abnormal uterine bleeding (AUB). In this study it is aimed to evaluate the correlation of clinical and histopathological examination (HPE) of these entities leading to abnormal uterine bleeding.

Methods

This retrospective study was carried out on hysterectomy specimens of subjects who presented themselves in the department of obstetrics and gynaecology of Sri Guru Ram Das Institute of medical sciences and research, Amritsar with chief complaints of AUB not responding to conservative treatment.

Results

A total of 100 women with clinical diagnosis of AUB in which hysterectomies were performed, leiomyoma was found in 42% cases, adenomyosis in 22% cases. The most frequent combination of diagnosis was leiomyoma and adenomyosis i.e. 26%. In 9% cases chronic cervicitis and ovarian cyst were detected. In one case endometrial malignancy was found.

Conclusions

Though adenomyosis and leiomyoma are clinically diagnosed along with other pathological conditions of the reproductive organs but their confirmation is still to be relied upon HPE; a most important investigation. Metrics

References

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