Correlation between Clinico-pathological and Ultrasonographical Findings in Hysterectomy 737-740
Dr. Thamilselvi Ramachandran
Associate professor, Department of pathology,
VMKV Medical college, Salem, Tamilnadu.
Introduction: Hysterectomy is the most commonly performed gynaecological surgery throughout the world. Total abdominal hysterectomy is the procedure of choice in conditions other than uterovaginal prolapse. Menorrhagia is the most common clinical symptom which is seen in the pre and the perimenopausal age group. All perimenopausal women with persistent abnormal uterine bleeding should be evaluated for the presence of endometrial hyperplasia or carcinoma by ultrasound or biopsy.
Objectives: To identify the most common pathology in hysterectomy specimens To correlate the clinical diagnosis and ultrasonographical findings with histopathological diagnosis.
Materials and Methods: Ours was a retrospective study analysis of hysterectomy cases, over a period of one year from Jan 2010 to Dec 2010 in the Department of Pathology, Vinayaka Missionâ€™s Kirubananda Variyar Medical College. The patients also underwent pelvic and transvaginal ultrasonography. Ninety eight percent of the hysterectomies were done for benign indications.
Results: The total number of hysterectomy specimens received were 234. The peak age of the patients was 31â€“40 years. A high incidence of the disease was seen in multiparous. In our study, 171 patients underwent pelvic ultrasound and transvaginal ultrasound, especially those who were in the peri and postmenopausal age group. Ultrasound detected 100% malignancy, 95% fibroids and 80% in adenomyosis. The commonest indication for transabdominal hysterectomy was fibroids in 30.7% of the cases. The most common pathology which was identified was leiomyoma followed by adenomyosis.
Conclusion: This study confirmed that benign diseases were more common in hysterectomy specimens than in their malignant counterparts. Out of the clinical diagnosis, ultrasonographical findings and histopathological diagnosis, histopathological diagnosis was found to be the gold standard to ensure the final diagnosis as the management of the malignant disease varied in the benign and malignant diseases.