REMZİ ATILGAN, Abdullah BOZTOSUN, Mehmet Reşat ÖZERCAN

Histerektomi materyallerinde histopatolojik tanıların insidansı

Amaç: Bu çalışmada histerektomi için klinik endikasyonların sıklığı ve histerektomi materyallerindeki en yaygın patolojiler tanımlandı. Gereç ve Yöntem: Ekim 2007 ile Ekim 2009 arasında 361 histerektomi materyali tekrar gözden geçirildi ve patolojik tanılar araştırıldı. Bulgular: Histerektomi için en yaygın klinik endikasyon leiomyoma (% 31.85) idi. Diğer klinik endikasyonlar endometrial hiperplazi (% 27.14), disfonksiyonel uterin kanama (% 18.55), uterus prolapsusu (% 9.14), kronik pelvik ağrı (% 7.20), adenomyozis (% 3.87), servikal neoplazi (% 2.21) idi. En yaygın tanımlanan patoloji leiomyoma (% 40.16) idi. Diğer patolojiler endometrial hiperplazi (% 38.22), adenomyozis (% 25.48), endometrial polipler (% 8.86), CIN 1 ( % 3.32 ), CIN 2 ( % 1.66 ) ve atrofik endometrium (% 3.60) idi. Yüzellisekiz (% 43.76) histerektomi materyalinde kombine patolojiler tanımlandı. En yaygın kombinasyon leiomyoma ve endometrial hiperplazi (% 38.60) idi. Diğer kombine patolojiler adenomyozis ve endometrial polip (% 17.72), adenomyozis ve leiomyoma (% 12.65), leiomyoma ve endometrial polipler (% 8.22) idi. Sonuç Endometrial patolojiler nedeniyle özellikle premenapozal ve postmenapozal dönemde opere edilecek olgularda servikal neoplazilerin beraber olabileceği unutulmamalıdır. Bu nedenle endometrial örnekleme yaparken endoservikal örneklemeninde yapılması önemlidir.

The ıncidence of histopathologic diagnosis in hysterectomy specimens

Objective: This study identified the frequency of clinical indications for hysterectomy and the most common pathologies in hysterectomy specimens. Material and Methods: A total of 361 hysterectomy specimens between October 2007 and October 2009 were retrieved and studied Results: The most common indication for hysterectomy was leiomyoma (31.85 %). Other indications were endometrial hyperplasia (27.14 %), dysfunctional uterine bleeding (18.55 %), uterine prolapse (9.14 %), chronic pelvic pain (7.20 %), adenomiyosis (3.87 %), cervical neoplasia (2.21 %). The most common pathology identified was leiomyoma (40.16 %). Other pathologies included endometrial hyperplasia (38.22 %), adenomyosis (25.48 %), endometrial polyps (8.86 %), CIN 1 (3.32 %), CIN 2 (1.66 %) and atrophic endometrium (3.60 %). In 158 (43.76 %) of hysterectomy specimens combined pathology was identified. The most common combination was leiomyoma and endometrial hyperplasia (38.60%). Other combined pathologies included adenomoysis and endometrial polyps (17.72 %), adenomyosis and leiomyoma (12.65 %), leiomyoma and endometrial polyps (8.22 %). Conclusion: The existence of cervical disorders should be demonstrated when an operation is going to be performed for an endometrial pathology in a pre or postmenopausal woman. Cervix and cervical canal should be examined during endometrial evaluation.

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