Clinical and histopathological correlation between pre-operative presumptive and post-operative definitive diagnosis for cases subjected to abdominal hysterectomy

ABSTRACT

This study was carried on 50 cases of abdominal hysterectomy. Post-operative gross and histopathology was carried out for the specimens received after the operation [uterus, cervix, tubes, and ovaries], and the results were matched with the preoperative clinical diagnosis. The main indications for abdominal hysterectomy were, uterine myoma, dysfunctional uterine bleeding and ovarian masses or cyst. The post operative diagnosis of adenomyosis was recorded in 38% of cases compared to 4% pre-operatively. The endometrial lesion detected post-operatively were, adenomatous hyperplasia without atypia in 20% of cases, cystic glandular hyperplasia [10%] retrogressive endometrial hyperplasia [8%]. Cases with uterine myoma was associated with, follicular cyst of the ovary [18%], adenomyosis [16%], endometrial hyperplasia [8%], and adenocarcinoma [2%]. Post-operative pathological confirmation of cases diagnosed pre-operatively on account of ovarian mass or cyst was found to be, simple serous cyst [43.5%], malignant granulosa cell tumor [14.5%], mucinous cystadenoma [14.5%], tubo ovarian abscess [14.5%]. This makes the past-operative pathological examination as essential step for both the confirmation of the diagnosis and follow up treatment. So whenever hysterectomy is planned for women with dysfunctional uterine bleeding, the abdominal approach should be chosen because the first step in the operation is to make certain that an organic lesion has not been overlooked. Moreover the preoperative perparation of the patient must he carried out in such away as to identify all disorders that might complicate the operation or the convalescence