Title: Histo-Pathological Evaluation in Cases of Hysterectomy Specimens in Tertiary Care Hospital at Muzaffarpur, Bihar

Authors : Dr Soma Thakur, Dr Manoj Kumar, Dr Raghvendra Kumar, Dr Mahesh Prasad

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.149

Abstract

Objective: This study was a prospective observational study. The aim of present study was to find out the most common Pathological cause of hysterectomy in tertiary care Hospital and incidence of hysterectomy in different age groups. It was also aimed to correlate the clinical, Pathological and radiological findings.

Materials and Methods: A total of 150 Patients of different age groups comes with different chronic complains in (Gynecology and obstetrics OPD) GOPD were studied. All patient after Pathological and radiological evaluation, undergone hysterectomy and all the specimens were received in the department for Histopathological examination.

Result: Out of 150 Patients, 72 (48%) Patients belongs to age groups of 40-49 years and 33(22%) cases belongs to age group of 30-39 Years. The most common presenting symptoms of patients undergoing hysterectomy was prolapse of uterus in 64 (42.6%) cases. Menorrhagia was the second most common complains in 57 (38%) cases. Most common clinical indication of hysterectomy was prolapse of uterus in 64 Patients (42.6%), Followed by Leiomyoma in 24 Patients (16%), carcinoma of cervix was found only in 1 patient (0.7%)

The most common histopathological finding was atrophic/Proliferative/ Secretory endometrium in 64 Patients (42.6%) followed by adenomyosis in 32 (21.33%) cases and Leiomyoma in 27 (18%) cases.

Conclusion: Histopathological evaluation of all cases of hysterectomy specimen were done. In most of the cases proper pathological cause and discussion of the condition of the women were not done due to various Pre- hysterectomy symptoms. Women abstain from work and routine duties. These problem can we avoided by proper diagnosis and treatment.

Keywords: Hysterectomy, Histopathological examination, DUB, Leiomyoma, Uterus.

References

  1. Gray's anatomy: The anatomical basis of clinical practice. 40th ed. Spain: Churchill Livingstone, 2008: 1258-1259, 1254.
  2. Kurman, edited by Robert J. (1994) Blaustein's Pathology of Female Genital Tract (4th ed.) New York, NY: Springer New York. 185-201.
  3. Drake, Richard L.; Vogal, Wayne, Tibbits, Adam W.M. Mitchell; Illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia, PA: Elsevier/Churchill Livingstone. 415,423.
  4. Ovalle, William K; Nahirney, Patrick C.; illustrations by Frank H. Netter, contributing . illustrators, Joe Chovan... (et al) (2013). Female Reproductive system. Netter's Essential Histology (end ed.). Philadelphia, PA; Elsevier/Saunders, 416.
  5. Langman's Medical Embryology, Lippincott Williams and Wilkins, 10th ed. 2006. 6. Ross M, Pawlina W (2011). Histology: A Text and Atlas (6th ed.) Lippincott Williams and Wilkins.
  6. Young B, Lowe JS, Stevens A, Heath JW. Wheater's functional histology. 5th ed. Churchill Livingstone, 2006.
  7. Hubert Guedj, Baggish, Michael S. Valle, Rafael Heliodoro (2007). Hysteroscopy: Visual perspectives of uterine anatomy, physiology and pathology. Hagerstwon, MD: Lippincott Williams and Wilkins. p.488.
  8. Rose PG. Endometrial Carcinoma. N. Engl J Med. 1996, 335: 640-649.
  9. Moll R, Levy R, Czernobilsky B, Hohlweg Majert P, Dallenbach Hellweg G, Franke WW. Cytokeratins of normal epithelia and some neoplasms of female genital tract. Lab Invest 1983, 49: 599-610.
  10. Barwick KW, Livolsi VA, Malignant Mixed Mullerian tumours of uterus. Am J Surg Pathol 1979, 3: 125-135.
  11. Dellers EA, Valente PT, Edmands PR, Balsara G. Mixed mesodermal tumours. An immunohistochemical study. Arch Pathol Lab Med 1991, 115: 918-920.
  12. Christopherson WM, Williamson E0, Gray LA, Leiomyosarcoma of uterus. Cancer 1972, 29: 70-75.
  13. Taylor HB, Norris HJ, Mesenchymal tumours of uterus IV, Diagnosis and prognosis of leiomyosarcomas. Arch Pathol 1966, 82: 40-44.
  14. Moinfar E. Azod; M. Tavarsol, FA, Uterine sarcomas, P athology 2007, 39: 55-71.
  15. Ferry JA, Young RI I, Malignant lymphoma of genitourinary tract. Curr Diagn Pathol 1997, 4: 145-169.
  16. Clement PB. Pathology of endometriosis. Pathol Annu 1990, 25: 245-295.
  17. Bell DA, Ovarian surface epithelial — stromal tumours. Hum Pathol 1991, 22: 750-762.
  18. Chaitin BA, Gershenson DM, Evans HL. Mucinous tumours of ovary. A clinicopathologic study of 70 cases. Cancer 1985, 55: 1958-1962.
  19. Roth LM, Czernobilsky B. Ovarian Brenner, tumours. 11. Malignant. Cancer 1985, 56: 592-601.
  20. Asadourian LA, Taylor HB, Dysgerminoma. An analysis of 105 cases. Obstet Gynecol 1969, 33: 370-379.
  21. Thamil Sevil Ramachandran, Rammy Sinha, Subramanium, Correlation between clinicopathological and ultrasonographic findings. Journal of clinical Diagnosis and Research 2011; 5(4): 734-740.
  22. Karthikeyan T.M., Dr. Veena NN, Dr. Ajeeth Kumar CR, Dr. Eliz Thomes. Clinicopathological study of Hysterectomy among rural patients in a Tertiary care center, IOSR. Journal of Dental & Medical Sciences, vol.14, Issue 5 Ver. IV (May 2015), pp.25-27.
  23. Shergill SK, Shergill HK, Gupta M, Kaur S. Clinicopathological study of hysterectomies J Indian Med Assoc. 2002; 100(4): 238-39.

Corresponding Author

Dr. Soma Thakur

Tutor, Department of Pathology, Sri Krishna Medical College, Muzaffarpur