Histopathological Evaluation of Myometrial Lesions of the Uterus in Nnewi Teaching Hospital: (Five‑Year Retrospective Study)

Introduction: A 5‑year retrospective study to evaluate the lesions of myometrium (both nonneoplastic and neoplastic) in the hysterectomyand myomectomy specimens received in our institution. Aim: This research will serve as a baseline study of different myometrial lesions in the histopathology department of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. This is the first of such a study since the institution of the department. The study will also highlight myometrial lesions in relation to the age and mode of presentations as well as histopathological features. Methodology: The pathology report forms in the histopathology department NAUTH, Nnewi, were retrieved, and relevant information was extracted. Atotal of 290 cases of myometrial lesions were obtained within the study period, of which 283 cases that fulfilled the inclusion criteria were analyzed. The processed tissues and the slides stained with regular histochemical stain (hematoxylin and eosin) technique in this 5‑year study period were reviewed by the above researchers using multi‑headed microscope (®CARL ZEISS). Results: The myometrial lesions observed include leiomyoma, leiomyomata, leiomyosarcoma, leiomyoma coexisting with adenomyosis, adenomyosis, invasive carcinosarcoma, and hemorrhagic necrosis following uterine rupture. The age range at the presentation was between 10and 80 years. The mean age for leiomyoma was 39.24 ± 8.41 standard deviation (SD), whereas the mean age for adenomyosis was 43 ± 9.86 SD.Leiomyoma was the most common myometrial lesion with a frequency of 93.9% (266 cases) and show degenerative changes in 139 cases (52.%)Followed by coexisting leiomyoma with adenomyosis which had a frequency of 3.9% (11 cases). Atotal of 184 leiomyoma cases with a frequencyof 69.2% occur in multiple nodules. Adenomyosis alone had a frequency of 3.18% (9 cases). Therefore, the total number of adenomyosis inthis research was 20 cases. Menorrhagia was the most common clinical symptoms with a frequency of 31.4% (82 cases). Leiomyosarcomahad a frequency of 1.77% (5 cases), whereas the least represented were hemorrhagic necrosis and invasive carcinosarcoma with frequenciesof 2 (0.8%) and 1 (0.4%), respectively. Conclusion: (1) Leiomyoma is the most common myometrial lesions and tends to coexist in a few cases with adenomyosis while majority of them show degenerative changes. (2) Menorrhagia is the most common presenting symptoms of myometrial lesions while the histologic examination is the only tool to differentiate these myometrial lesions with similar clinical symptoms. Keywords: Adenomyosis, invasive carcinosarcoma, leiomyoma, leiomyosarcoma, menorrhagi

Histopathological Profile of Primary Ovarian Lesions in Nnewi, Nigeria: A 5 Year Retrospective Study

Background: This is the first base line research on different primary ovarian lesions in Histopathology department, Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi since the institution of the hospital.Objectives: To determine the different patterns of ovarian lesions in relation to age and histopathological features and compare these patterns with local and international studies. The study will also highlight the most common histologic variants in our environment and make recommendations depending on the outcome of the research.Methodology: The pathology report forms of all the gynaecological lesions in histopathology department NAUTH, Nnewi, were studied. The processed tissue and the slides stained with regular histochemical stain (Haematoxylin and Eosin) technique in this 5-year study period were reviewed by the researchers using multi-headed microscope (CARL ZEISS®).Results: Of the 130 cases that were analysed, 91 (70.0%)cases were neoplastic while 39(30.0%) cases were non-neoplastic lesions. Benign neoplasms were the most common neoplasm and accounted for 56.0% (51 cases) followed by invasive malignant neoplasms with 31.9% (29 cases) while borderline and indeterminate tumours, were 3.3% (3 cases) and 8.8% (8 cases). respectively. Among the benign neoplastic lesions, mature cystic teratoma was the most common tumour (no= 22, 16.9%) with the patients’ mean age of 33.1 ±SD 13.0, followed by serous cystadenoma (no=15, 11.5%) with a mean age of 33.4 ±SD 12.9. However, high grade papillary serous cystadenocarcinomas (no=13, 9.8%) were the highest recorded invasive malignant lesions with a mean age of 49.8 ± SD 15.9) followed by choriocarcinoma (no.=5, 3.8%) with a mean age of 35.3 ±SD 9.7. Immature teratoma and mucinous cystadenocarcinoma were 4 (3.1%)cases each with mean ages of 20.8 ± SD 13.9 and 55.3 ± SD 14.3, respectively. Malignant germ cell tumours; immature teratoma and choriocarcinoma, formed only 28.1% of all germ cell tumours. Of the non-neoplastic lesions, corpus luteum cyst and follicular cyst were the most common with 11 cases (8.5%) and 10 cases (7.7%), respectively.Conclusion: Ovarian neoplasia are quite diverse, and in our environment, benign lesions of the ovary were far more common than malignant cases and tend to occur at the reproductive age group. Surface –epithelial neoplasms were more common than germ-cell tumours with a ratio of 1.4:1. Majority of invasive malignant cases were high grade serous cystadenocarcinoma. Keywords: Corpus luteum cyst, Follicular cyst, Teratoma, Cyst adenoma, Borderline tumour, Serous cystadenocarcinom