A Spectrum of Histopathological Findings in Hysterectomy Specimens at a Tertiary Care Center in Western Nepal: A Descriptive Study

Laxmi Lama, Asmita Karki, Anupa Khanal, Dipesh Shrestha, Sahesh Gopal Vaidya, Prasamsha Bajracharya, Swostika Khatri
In: Medical Journal of Armed Police Force Nepal · 2026 · vol. 2(1) , pp. 51–56 · doi:10.64772/mjapfn.2.1.34 · W7129071802
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This retrospective study of 210 hysterectomy specimens in Nepal identified a wide spectrum of histopathological findings, including adenomyosis in 9.52% of cases, highlighting the necessity of thorough microscopic evaluation regardless of gross appearance.

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This retrospective descriptive study analyzed histopathological findings in 210 hysterectomy specimens collected from a tertiary care center in Western Nepal between November 2022 and July 2025. The research identified proliferative phase endometrium as the most common endometrial lesion, while leiomyoma was the predominant myometrial pathology affecting over forty percent of cases. Adenomyosis was detected in twenty patients, representing approximately nine and a half percent of the cohort, alongside various ovarian lesions including corpus luteal cysts and rare malignancies. Relevance to endometriosis: adenomyosis is listed as one of the pathologies evaluated in this descriptive spectrum of hysterectomy findings, though the paper does not focus exclusively on it or discuss endometriosis beyond mentioning it in the introduction.

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Abstract

Introduction: Hysterectomy is a widely performed major surgical procedure in women globally. It is performed as a definitive treatment for several pathologies of female reproductive organs, which include uterine fibroids, uterine prolapse, abnormal uterine bleeding, adenomyosis, endometriosis, and malignancies. The current study aimed to assess the spectrum of histopathological findings in hysterectomy specimens. Methods: A retrospective descriptive study was conducted in the Department of Pathology from November 2022 to July 2025 after ethical approval from the Institutional Review Committee. (Reference number: IRC-LMC-07/2025) A total of 210 women were enrolled who presented with a clinical diagnosis of female genital tract lesions. Clinical details, including age of patients, preoperative diagnosis and type of surgical procedure, were retrieved from medical records of the Department of Obstetrics and Gynaecology. All slides were observed under a light microscope by the consultant pathologist. Descriptive data were analyzed statistically, and SPSS software version 25 was used for the analysis. Results: Among the specimens observed, the most predominant endometrial lesions were proliferative phase endometrium in 103 (49%) cases, followed by atrophic endometrium in 51 (24.28%) cases. Leiomyoma was the most common myometrial lesion in 90 (42.85%) cases, and adenomyosis was seen in 20 (9.52%). The ovaries manifested various lesions; the corpus luteal cyst was the most frequently encountered lesion, seen in 23 (16.31%) cases and two malignant tumors one high-grade serous carcinoma and one transformed teratoma. Conclusions: The current study revealed that a wide spectrum of lesions can be identified on histopathological examination. Therefore, it is essential that all hysterectomy specimens undergo thorough histopathological evaluation even when they appear grossly normal.
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Introduction

Hysterectomy is a widely performed major surgical procedure in women globally. It is performed as a definitive treatment for several pathologies of female reproductive organs, which include uterine fibroids, uterine prolapse, abnormal uterine bleeding, adenomyosis, endometriosis, and malignancies. The current study aimed to assess the spectrum of histopathological findings in hysterectomy specimens.

Methods

A retrospective descriptive study was conducted in the Department of Pathology from November 2022 to July 2025 after ethical approval from the Institutional Review Committee. (Reference number: IRC-LMC-07/2025) A total of 210 women were enrolled who presented with a clinical diagnosis of female genital tract lesions. Clinical details, including age of patients, preoperative diagnosis and type of surgical procedure, were retrieved from medical records of the Department of Obstetrics and Gynaecology. All slides were observed under a light microscope by the consultant pathologist. Descriptive data were analyzed statistically, and SPSS software version 25 was used for the analysis.

Results

Among the specimens observed, the most predominant endometrial lesions were proliferative phase endometrium in 103 (49%) cases, followed by atrophic endometrium in 51 (24.28%) cases. Leiomyoma was the most common myometrial lesion in 90 (42.85%) cases, and adenomyosis was seen in 20 (9.52%). The ovaries manifested various lesions; the corpus luteal cyst was the most frequently encountered lesion, seen in 23 (16.31%) cases and two malignant tumors one high-grade serous carcinoma and one transformed teratoma.

Conclusions

The current study revealed that a wide spectrum of lesions can be identified on histopathological examination. Therefore, it is essential that all hysterectomy specimens undergo thorough histopathological evaluation even when they appear grossly normal. Downloads Published Issue Section License Copyright (c) 2026 Medical Journal of Armed Police Force Nepal This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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