Leiomyomas in Hysterectomy Specimens: A Clinicohistopathological Study

Abstract

BACKGROUNDUterine leiomyomas are the most common uterine neoplasms. They occur in as many as 75% of uteri. All women of reproductive age group are vulnerable and may experience clinical features like pain, abnormal uterine bleeding, abdominal mass and infertility or pregnancy complications, rendering knowledge of their pathogenesis and morphology essential. This study was undertaken to perform histopathological evaluation of leiomyomas. MATERIALS AND METHODS4223 hysterectomy specimens were examined for presence of leiomyomas and detailed histomorphological analysis was done for specimens with leiomyomas. RESULTSLeiomyomas were seen in 1590 (37.65%) specimens. Age of patients ranged from 22-80 years with most cases (54.53%) in 41-50 years age group and average age of 44.09 years. The most common clinical complaints were menorrhagia (45.97%), abdominal pain (18.99%), dysmenorrhea (11.95%) and abdominal mass (7.99%). Fibroid was unitary in 52.01% and multiple in 47.99% specimens. They were mostly located intramurally (80.25%). Degenerative changes like hyalinization (13.33%), hydropic degeneration (5.22%), myxoid change (2.14%), haemorrhage (1.01%), calcification (0.94%) and red degeneration were observed. Few cases of cellular, symplastic, neurilemmoma like and epithelioid variants, lipoleiomyoma, angioleiomyoma, mitotically active leiomyoma, dissecting leiomyoma and leiomyoma with hyaline globules were seen. One case was leiomyosarcoma on histopathology. Adenomyosis occurred concurrently with leiomyoma in 31.07% cases. CONCLUSIONLeiomyomas are usually present intramurally. More than half occur singly. Secondary degenerative changes and occasionally variants of leiomyoma may be encountered. Cellular, mitotically active and symplastic variants need to be differentiated from leiomyosarcoma. Adenomyosis and leiomyoma are found to coexist frequently.