Proceedings of the Third International Conference of the College of Medicine, Hawler Medical University
Patterns of Uterine Leiomyoma in Hysterectomy Specimens: A Clinicopathological Study in Erbil Maternity Hospital
Payman A. Rashid, Department of Basic Sciences, College of Medicine, Hawler Medical University, Erbil, Iraq
E- mail: [email protected]
Samir M. Othman, Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
Published: 21 Jan 2019
Background and objective: Leiomyoma is the commonest benign uterine tumor seen in women of reproductive age group. Hysterectomy specimens contribute a major component of histopathological work in Pathology laboratories. This study aimed to evaluate the association between leiomyoma and various clinical and histopathological changes in hysterectomy specimens.
Methods: This retrospective study was conducted in the histopathology laboratory of Maternity Teaching Hospital in Erbil /Kurdistan region of Iraq over a period of one year from February 2016 to February 2017. A total of 238 hysterectomy specimens with or without bilateral salpingo-oophorectomy were received by the pathology laboratory in which 110 cases where diagnosed as leiomyoma. The blocks were sectioned and stained with hematoxylin and eosin. A detailed microscopic examination of the tumors was done. Patient’s age, clinical presentation and clinical indication as well as the type of hysterectomy were reviewed. The association between the clinical parameters and the pathological findings was estimated.
Results: A total of 238 hysterectomy specimens were received in which 110 cases of them were with uterine leiomyomas, (55.5%) were in the fourth decade and (85.5%) of them were multiparous. The most common presentation was menorrhagia (79.1%), (51.8%) were multiple leiomyoma in multiple locations. Hyalinization is the most common secondary changes (28.2%) and proliferative phase was the commonest endometrial changes seen (45.5%). Adenomyosis (59.1%) and ovarian cysts (21.8%) are the most common pathologies associated with leiomyoma.
Conclusion: Our study concludes that leiomyoma is frequent benign tumor of the uterus in Erbil city. They are commonly seen in perimenopausal females and menorrhagia is commonest presentation. Multiple leiomyoma in multiple locations are common and hyaline change was the most common secondary degenerative changes. The presence of proliferative endometrium, adenomyosis and cystic ovaries all are indicate that high estrogen state play the major role in development of leiomyoma.
Keywords: Leiomyoma, degenerative changes, hysterectomy.