The Evaluation of Histopathologic Diagnosis in Specimens of Hysterectomy

Year 2013, Volume: 2 Issue: 2, 91 - 94, 01.05.2013

Ünal İsaoğlu Mehmet Yılmaz İlhan Bahri Delibaş İlay Gözükara Ahmet Erkan Bilici Paşa Uluğ Eşref Kabalar

https://doi.org/10.5505/abantmedj.2013.30502

Abstract

OBJECTIVE: To evaluate hysterectomy procedures performed for benign conditions in terms of indications and histopathological resultsMETHODS: Retrospective analysis of 258 hysterectomy cases, which were performed between January 2011 and December 2012, was conducted to review indications and histopathological diagnoses. RESULTS: : The most frequent indications for hysterectomy were abnormal uterine bleeding 87, 33,72% , myoma uteri 73, 28,29% and endometrial hyperplasia 67, 25,96% , respectively. Other clinical indications were adenomyosis 25, 9,68% and uterine prolapse 6, 2,32% . The most common histopathological diagnoses reported for hysterectomy specimens were leiomyoma 83, 32,17% , adenomyosis 78, 30,23% and endometrial hyperplasia 77 29,84% , respectively. Endometrial polyp was diagnosed in specimens of 13 patients 5,04% . Endometrial atrophy was reported in 7 patients 2,71% . Cervical histopathology of hysterectomy materials revealed chronic cervicitis in 54,26% of the patients.CONCLUSION: Due to the high coincidence of myoma uteri and endometrial hyperplasia, endometrial sampling should be performed in patients who are being considered for hysterectomy for myoma uteri and also have menometrorrhagia.

Keywords

Hysterectomy, Indication, Pathology

Histerektomi Materyallerinde Histopatolojik Tanıların İncelenmesi

Abstract

AMAÇ: Bu çalışmada benign ön tanılarla yapılan histerektomilerin, endikasyonlar ve histopatolojik tanılar açısından değerlendirilmesi amaçlandı.YÖNTEMLER: Ocak 2011 ile Aralık 2012 yılları arasında yapılmış olan 258 histerektomi olgusu endikasyonlar ve histopatolojik tanılar açısından retrospektif olarak değerlendirildi.BULGULAR: En sık histerektomi endikasyonu anormal uterin kanama idi 87 %33,72 . Daha sonra sırası ile myoma uteri 73 %28,29 ve endometrial hiperplazi 67 %25,96 olarak tespit edildi. Diğer klinik endikasyonlar adenomyozis 25 % 9,68 ve uterus prolapsusu 6 % 2,32 idi. Histerektomi materyallerinin histopatolojik raporları incelendiğinde, en yaygın patoloji leiomyoma 83 %32,17 , takiben adenomyozis 78 % 30,23 ve endometrial hiperplazi 77 29,84 idi. Endometrial polip 13 % 5,04 vakada tespit edildi. 7 % 2,71 vakada ise atrofik endometrium mevcuttu. Yine histerektomi materyallerinin serviks incelemelerinde olguların % 54,26’sında kronik servisit olduğu gözlendi.SONUÇ: Myoma uteri ile endometrial hiperplazilerin yüksek oranda birlikteliği nedeniyle myoma uteri tanısıyla histerektomi planlanan hastalarda menometrorajide mevcutsa mutlaka endometrial örnekleme de yapılmalıdır.

Keywords

Histerektomi, Endikasyon, Patoloji

References

• Benrubi GI. History of hysterectomy. J Fla Med Assoc, ; 75: 533-8. Pokras R. Hysterectomy, past, present and future. Stat Bull Metrop Insur Co, 1989: 7012-21.
• Davies A, Magos A. Indications and alternatives to hysterectomy. Bailliere’s Clin Obstet and Gynaecol 1997; : 64- 7.
• Coulter A, Bradlow J, Agass M, Martin-Bates C, Tulloch A. Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records. Br J Obstet Gynaecol 1991; 98: 789-96.
• Vessey MP, Villard-Mackintosh L, McPherson K, Coul- ter A, Yeats D. The epidemiology of hysterectomy: find- ings in a large cohort study. Br J Obstet Gynecol 1992; 99: 7.
• Rock AJ, Jones WH (eds). Te Linde’s Operative Gyne- cology 9th ed. Chap 30. Philadelphia: Wiliams & Wilkins Lippincott 2003; 753-98.
• Lepine LA, Hillis SD, Marchbanks PA, Koonin LM, Mor- row B, Kieke BA, Wilcox LS. Hysterectomy surveillance- United States 1980-1997. MMWR 1997; 46: 1-15.
• Cramer SF, Patel A. The frequency of uterine leiomyo- mas. Am J Clin Pathol 1990; 94: 435-8.
• Dinçgez B, Coşkun Eİ, Ayanoğlu YT. Kliniğimizde gerçekleştirilen histerektomi olgularının değerlendirilme- si. Şişli Etfal Hastanesi Tıp Bülteni 2011; 45: 35-8.
• Bukhari U, Sadiq S. Analysis of the underlying patho- logical lesions in hysterectomy specimens. Pak J Pathol ; 18: 110-12. Ojeda VJ. The pathology of hysterectomy specimens. Z Med J 1979; 89: 169-71.
• Atılgan R, Boztosun A, Ozercan MR. Histerektomi materyallerinde histopatolojik tanıların insidansı. Fırat Tıp Dergisi 2012; 17: 19-229.
• Atri M, Reinhold C, Mehio AR, Chapman WB, Bret PM. Adenomyosis: US features with histologic correlation in an invitro study. Radiology 2000; 215: 783-90.
• Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyen- decker G. Adenomyosis in endometriosis prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod 2005; 20: 2309-16.
• Çakmak B, Özsoy Z, Hısım Y, Nacar M, Metin FZ, Demirtürk F. Benign endikasyonlar nedeniyle uygulanan histerektomi materyallerinde adenomyozis sıklığı. Çağdaş Tıp Dergisi 2012; 2: 158-161.
• Lee NC, Dicker RC, Rubin GL, Ory HW. Confirmation of the preoperative diagnoses for hysterectomy. Am J Obstet Gynecol 1984; 150: 283-7.
• Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long term study of ‘untreated’ hyperplasia in 170 patients. Cancer 1985; 56: 403–12.
• Terakawa N, Kigawa J, Taketani Y, Yoshikawa H, Yaji- ma A, Noda K et al. The behavior of endometrial hyper- plasia: a prospective study. Endometrial Hyperplasia Study Group. J Obstet Gynaecol Res 1997; 23: 223–30.
• Sherman ME, Mazur MT, Kurman RJ. Benign diseases of the endometrium. In: Kurman RJ, editor. Blaunstein’s pathology of the female genital tract. 5. edition. New York: Springer, 2002; 421–66.
• Reslova T, Tosner J, Resl M, Kugler R, Vavrova I. En- dometrial polyps. A clinical study of 245 cases. Arch Gy- necol Obstet 1999; 262: 133-9.
• Shegill SK, Shergill HK. Clinicopathological study of hysterectomies. J Indian Med Assoc 2002; 100: 238-9.
• Talukder SI, Haque MA, Hug MH, Alam MO, Roushan A, Noor Z, Nahar K. Histopathological analysis of hysterec- tomy specimens. Mymensing Med J 2007; 16: 81-4.