Frequency and Spectrum of Non-Malignant Lesions in Abdominal Hysterectomy Specimens

Abstract

Objective: To determine the histological spectrum of non-malignant lesions in abdominal hysterectomy specimens from women of reproductive age group.

Study design and setting: This was a descriptive cross-sectional study carried out at a private hospital in Karachi from December 2018 to December 2019.

Methodology: The uterine specimens of patients (n=262) between the ages of 24 to 55 years were collected. Hysterectomies done due to any benign uterine disease were included in the study. Hysterectomies due to malignant causes were excluded. Pathological diagnosis was done on light microscopy using routine hematoxylin and eosin staining technique. Data collected during the study period included patient's age, clinical history/diagnosis and histological diagnosis. On receiving the hysterectomy specimens as per protocol,specimens were immediately put in 10% formalin, appropriately labeled for patient’s name, gender, age and procedure. In histopathology lab, grossing of the specimens was done using standard protocols. 

Results: Total n=262 hysterectomies were received. Mean age of all the patients was 34.7 years ±7.8. Non-malignant uterine pathologies on histopathology included 124(47.7%) leiomyomas, 52(20%) adenomyosis, 32(12.3%) endometrial polyps, 16(6.2%) endometrial hyperplasia, 6(2.3%) endometritis, 3(1.2%) disordered proliferative endometrium and 1(0.4%) endometrial stromal nodule. Rest of the cases showed normal phases of endometrial cycle.Only two cases (0.76%) out of 262 received as clinically benign uterine disease, were diagnosed as malignant on histopathology.

Conclusion: Leiomyoma is the most common uterine pathology diagnosed in clinical setting as well as encountered at histopathological examination followed by Adenomyosis and endometrial polyps in women of reproductive age group in Pakistan.