Histopathological spectrum of uterine lesions in hysterectomy specimens of patients with abnormal uterine bleeding

In: International Journal of Clinical Trials · 2024 · vol. 11(4) , pp. 252–259 · doi:10.18203/2349-3259.ijct20242672 · W4402532344
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AI-generated summary by claude@2026-06, 2026-06-08

This study analyzed 140 hysterectomy specimens from patients with abnormal uterine bleeding, finding leiomyoma as the most common lesion, followed by adenomyosis with leiomyoma and adenomyosis alone.

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This cross-sectional observational study analyzed 140 hysterectomy specimens (with or without salpingo-oophorectomy) from patients with abnormal uterine bleeding, using histopathological examination to characterize the range of uterine lesions. The most common clinical presentation was heavy menstrual bleeding (83 cases), and the most frequent histopathological diagnosis was leiomyoma (83 cases), with adenomyosis plus leiomyoma identified as a dual pathology in 23 cases and adenomyosis alone in 19 cases. The paper reports additional findings including benign endometrial polyp, endometrial carcinoma, and other less common entities such as adenomyoma and endometrial stromal sarcoma. The study acknowledges that histopathology identified dual, incidental, and occult malignant lesions that could be missed clinically or radiologically, underscoring its role as a definitive diagnostic method. Relevance to endometriosis and/or adenomyosis: the study specifically includes adenomyosis (alone or coexisting with leiomyoma) among the histopathological spectrum found in hysterectomy specimens from AUB patients.

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Abstract

Background: Abnormal uterine bleeding (AUB) is an overarching term that reflects any departure from normal menstruation or regular menstrual cycle patterns. Treatment depends upon the cause. Hysterectomy being a definite treatment for structural uterine pathology. Methods: This cross-sectional observational study was conducted in department of pathology, Netaji Subhash Chandra Bose medical college Jabalpur (M.P.). The study comprised of 140 hysterectomy specimens with or without salpingo-oophorectomy obtained from AUB patients and submitted for histopathological examination in our department during study period of 18 months. The relevant data of the patients was collected and analyzed as per designed proforma. Results: Out of 140 cases, majority of the patients were in 41-50 years age group 63 cases (45%), followed by 31-40 years age group 59 cases (42.14%). Most common clinical presentation was heavy menstrual bleeding in 83 cases (59.28%), followed by intermenstrual bleeding and pain in abdomen in 66 cases (47.14%) each. Commonest lesion found was leiomyoma, 83 cases (59.28%), second being dual pathology of adenomyosis with leiomyoma 23 cases (16.42%) followed by adenomyosis, 19 cases (13.57%). Four cases (2.85%) of benign endometrial polyp and endometrial carcinoma each and 1 case of adenomyoma, simple endometrial hyperplasia and endometrial stromal sarcoma, each, were reported. Conclusions: A wide spectrum of histopathological findings, ranging from normal cyclic endometrium to benign pathology and malignancy were seen. In some patients, dual pathologies, incidental findings and occult malignant lesions, which were missed clinically or radiologically, was diagnosed on histopathological examination, thus making it a gold standard for definite diagnosis.
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Background

Abnormal uterine bleeding (AUB) is an overarching term that reflects any departure from normal menstruation or regular menstrual cycle patterns. Treatment depends upon the cause. Hysterectomy being a definite treatment for structural uterine pathology.

Methods

This cross-sectional observational study was conducted in department of pathology, Netaji Subhash Chandra Bose medical college Jabalpur (M.P.). The study comprised of 140 hysterectomy specimens with or without salpingo-oophorectomy obtained from AUB patients and submitted for histopathological examination in our department during study period of 18 months. The relevant data of the patients was collected and analyzed as per designed proforma.

Results

Out of 140 cases, majority of the patients were in 41-50 years age group 63 cases (45%), followed by 31-40 years age group 59 cases (42.14%). Most common clinical presentation was heavy menstrual bleeding in 83 cases (59.28%), followed by intermenstrual bleeding and pain in abdomen in 66 cases (47.14%) each. Commonest lesion found was leiomyoma, 83 cases (59.28%), second being dual pathology of adenomyosis with leiomyoma 23 cases (16.42%) followed by adenomyosis, 19 cases (13.57%). Four cases (2.85%) of benign endometrial polyp and endometrial carcinoma each and 1 case of adenomyoma, simple endometrial hyperplasia and endometrial stromal sarcoma, each, were reported.

Conclusions

A wide spectrum of histopathological findings, ranging from normal cyclic endometrium to benign pathology and malignancy were seen. In some patients, dual pathologies, incidental findings and occult malignant lesions, which were missed clinically or radiologically, was diagnosed on histopathological examination, thus making it a gold standard for definite diagnosis. Metrics

References

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