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

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.

A clinical study of elective hysterectomies for benign lesions

“…11,12 The peak age incidence of patients was 41-50 years, while the mean parity was 4, such figures are comparable to those reported in previous studies. [12][13][14] This is because the frequency of most common indication for abdominal hysterectomy i.e. leiomyoma, adenomyosis peak in the age group 31-50yr.…”

“…These findings are correlated well with the previous studies. 9,12,14,17 Vaginal route had less chance of post-operative complications as it is less invasive surgery with comparatively lesser disruption of tissue i.e. it avoids the dissection of skin, muscle, sheath, big portion of peritoneum and it also avoids handling of gut, similar to study conducted by AL-Kadri et al 18 As all hysterectomies were done post-menstrualy hence endometrium in maximum cases were in proliferative phase, fibroid and DUB being hyper-estrogenism and anovulatory would have proliferative endometrium.…”