Histopathological Correlation of Adenomyosis, Leiomyoma and Dual Pathology in Hysterectomy Specimens as the Cause of Abnormal Uterine Bleeding In Women in Different Age Groups

Abstract

Background: The objective was to study adenomyosis and leiomyoma as the cause of abnormal uterine bleeding in hysterectomy specimens. Methods: This was a study carried out on 100 hysterectomy specimens, of subjects who presented to the department of Obstetrics and Gynaecology at Government Medical College, Patiala with the complaint of abnormal uterine bleeding. Data including age, parity, symptoms and clinical indication for hysterectomy was collected for the study and the histopathological findings were recorded. The specimens were well grossed and stained with hematoxylin and eosin and examined microscopically. Results: Women in the perimenopausal age (41-50 years) accounted for the highest number of cases (35, 44.30%) presenting with symptoms of AUB. In this age group leiomyoma was found to be the commonest cause of AUB (19, 54.28%). The most common symptom was heavy menstrual bleeding. Clinical, radiological and pathological evaluation correlated well with the diagnosis of leiomyoma but was of little help in diagnosing adenomyosis. Conclusion: Hence, adenomyosis still remains a clinical challenge and should be kept in mind by the clinician as well as the pathologist in women presenting with AUB.

Spectrum of Lesions in Hysterectomy Specimens- A One Year Retrospective Study

“…The prevalence of leiomyoma as the cause of AUB is also quite common histopathological finding in hysterectomy specimens. In one such study 4 it was found that adenomyosis and leiomyoma was the main cause of AUB and as AUB is a common presentation in both the entities and the fact that these cannot be differentiated solely on clinical ground, necessitates the need of histopathological examination for confirmation. Vaginal hysterectomy is the method of choice for gynaecologists who carry out hysterectomies.…”