Awale Rupali, Isaacs Roma, Singh Shavinder, Mandrelle Kavita
Department of Laboratory Medicine, AIIMS, New Delhi, India.
Department of Pathology, Christian Medical College, Ludhiana, Punjab, India.
J Midlife Health. 2017 Oct-Dec;8(4):179-182. doi: 10.4103/jmh.JMH_80_17.
Uterine prolapse accounts for one of the common gynecological problems in India. The excised uterus is not expected to have any pathological finding other than atrophic endometrium and may be an ulcer because of the prolapse.
The aim of this study is to assess the hysterectomy specimen for unsuspected pathology.
The study is done over two and half years at a tertiary care hospital. Hysterectomy specimens done with a clinical indication of prolapse were included in the study. Histopathological examination done, findings noted, and data analyzed.
Descriptive analysis was used in this study.
Of the total hysterectomy specimens, 55 (6%) were done for uterovaginal prolapse. Patients age ranged from 32 to 78 years; mean 51.1 ± 11.9 years. Majority (46; 83.6%) of the patients were above 40 years of age, whereas only (9; 16.4%) were < 40 years of age ( < 0.0001) Vaginal hysterectomy was done in most 38 (69.1%) cases as compared to abdominal hysterectomy in 17 (30.9%) cases ( < 0.001). Adnexae were removed in only 3 (5.5%) cases as compared to 52 (94.5%) cases, in which adnexae were preserved ( < 0.001). Chronic cervicitis was seen in 100% of cases. Majority (18:32.7%) of the endometrium was in atrophic phase, secretory in 8 (14.5%), cystic regressive hyperplasia and chronic endometritis in 4 (7.2%) each. Myometrium was unremarkable in 43 (79%) cases, whereas focal adenomyosis in 12 (21%) cases. All the adnexa received were histologically unremarkable.
Grossly unremarkable specimens can have unsuspected histopathological lesion which could be potential premalignant or malignant lesions. Therefore, all hysterectomy specimens should be subjected to the histopathological examination for accurate diagnosis and proper categorization of lesions.
子宫脱垂是印度常见的妇科问题之一。切除的子宫除了子宫内膜萎缩外，预计不会有任何病理发现，并且由于脱垂可能会出现溃疡。
本研究的目的是评估子宫切除标本是否存在未被怀疑的病理情况。
该研究在一家三级护理医院进行了两年半。纳入了因临床指征为脱垂而进行子宫切除的标本。进行了组织病理学检查，记录了检查结果并进行数据分析。
本研究采用描述性分析。
在所有子宫切除标本中，55例（6%）是因子宫阴道脱垂而进行的。患者年龄在32岁至78岁之间；平均年龄为51.1±11.9岁。大多数患者（46例；83.6%）年龄在40岁以上，而年龄小于40岁的患者只有9例（16.4%）（P<0.0001）。大多数病例（38例；69.1%）采用了阴道子宫切除术，相比之下，17例（30.9%）采用了腹式子宫切除术（P<0.001）。仅3例（5.5%）病例切除了附件，而52例（94.5%）病例保留了附件（P<0.001）。100%的病例可见慢性宫颈炎。大多数子宫内膜（18例；32.7%）处于萎缩期，8例（14.5%）为分泌期，4例（7.2%）为囊性退行性增生和慢性子宫内膜炎。43例（79%）病例的子宫肌层无明显异常，而12例（21%）病例有局灶性子宫腺肌病。所有接收的附件在组织学上均无明显异常。
外观无明显异常的标本可能存在未被怀疑的组织病理学病变，这些病变可能是潜在的癌前病变或恶性病变。因此，所有子宫切除标本都应进行组织病理学检查，以准确诊断和正确分类病变。
