Histopathological Analysis of Hysterectomy Specimens with Clinicopathologic Correlation at HBS Medical College Laboratory

Abstract

Objective: To determine the frequency of various histopathologic lesions in the hysterectomy specimen received in HBS Laboratory and distribution of different lesions in relation to age and to correlate the histopathologic diagnosis with clinical diagnosis Methodology: This descriptive cross sectional study was conducted at the Department of Pathology, HBS Medical & Dental College & Hospital, Islamabad from January 21, 2019 to January 30, 2020. Eighty-four hysterectomy specimen including total abdominal hysterectomy (TAH), vaginal hysterectomy (VH), total abdominal hysterectomy with bilateral (TAH & BSO) between ages 20-70 years presenting with abnormal uterine bleeding (AUB) were included while hysterectomies due to pregnancy related complications were excluded. Data was collected by purposive sampling from patients who fulfilled the inclusion criteria on a predesigned proforma with presenting complaints and clinical diagnosis. Specimen were fixed in 10% buffered formalin and histopathologic diagnosis was done from hematoxylin and eosin stained slides of representative sections. The frequency of all types of histopathologic diagnosis was calculated and clinicopathologic correlation was done for structural lesions of uterus causing abnormal bleeding. SPSS version 20 was used for statistical analysis. Mcnemar test was used to find the concordance index. Results: The most common structural uterine lesion causing abnormal bleeding was leiomyoma (36 cases, (42.8%) followed by adenomyosis (21.4%). There was a strong clinicopathologic correlation in hysterectomy specimen. But clinically malignancy was suspected in more cases than it was diagnosed histologically (p=0.05) Conclusion: The most common non- endometrial pathology was leiomyoma and endometrial pathology was hormonal imbalance. The clinicopathologic correlation in hysterectomy specimen was good but histopathology is pivotal for the accurate diagnosis. Key Words: Total abdominal hysterectomy, leiomyoma, adenomyosis