HISTOMORPHOLOGICAL SPECTRUM OF UTERINE LEIOMYOMA VARIANTS- ONE YEAR RETROSPECTIVE STUDY IN A TERITARY CARE CENTRE.

Background:Benign leiomyomas were the most common pelvic tumor in women(1,,2,3) . Most myometrial tumors continue to be a major cause of morbidity and leading indication for hysterectomy in premenopausal women. And some of the leiomyoma variants,such as mitotically active leiomyoma, symplastic leiomyoma may simulate leiomyosarcoma or other malignant tumors as these tumors carry better prognosis and require detailed morphological study. In this study, we ascertained the frequency with which these variants were diagnosed and the difficulties that were encountered during the diagnosis. Materials and methods:A retrospective analysis of hysterectomy and myomectomy specimen that were received in our department, Institute of Social Obstetrics and Kasturba Gandhi Hospital for women and children, from April 2016 to April 2017 was performed. The details regarding patient age, clinical presentation were collected from the medical records. Results:During our study period, we received 1879 hysterectomy specimens and 664 specimens were found to have fibroid. We also received 29 myomectomy specimen and all these specimens were subjected for routine histopathological examination. Typical leiomyomas constituted to 88.6% and other variants like mitotically active leiomyoma, symplastic leiomyoma, cellular leiomyoma, neurilemmoma like variant, fatty degeneration, hyaline degeneration, calicification and hydropic degeneration constituted 11.4%. Conclusion:Variants of leiomyoma were relatively less, but it is important to differentiate them from malignant myometrial neoplasms, as they have good prognosis. Tumor size, cytological and nuclear atypia, mitosis and coagulative necrosis were the most important histological features for differentiation.