Abstract
Objective: To determine the frequency and histopathological pattern of endometrial lesions identified on hysterectomy specimen and correlate it with different age groups.
Methodology: This prospective cross-sectional study was carried out at Departments of Pathology and Gynecology & Obstetrics, Hayatabad Medical Complex, Peshawar from July 2015 to July 2020. A total of 587 hysterectomy specimens were included in the study and included both vaginal and abdominal hysterectomies. The grossing protocol of hysterectomy specimen was cervix: two sections, body & fundus of uterus: two sections and one section from both ovaries & fallopian tubes. One to multiple sections were obtained from leiomyomas & ovarian/uterine masses and cysts depending on their sizes. Tissue sections after staining with hematoxylin and eosin (H&E) were examined microscopically by expert histopathologists and reported.
Results: Out of 612 abdominal and vaginal hysterectomy specimens, 587 were included in the study. Thirty-three (5.6%) belonged to age group 21-30 years, 218 (37%) to age 31-40 years, 268 (45.6%) to age 41-50 years, 51 (8.7%) to 51-60 years and 17 (2.9%) belonged to age over 60 years. Two thirty-one (39.35%) patients had leiomyomas and 190 (32.36%) adenomyosis. While 62 (10.5%) patients revealed dual pathology i.e. both leiomyomas and adenomyosis. Fifty-seven (9.7%) had endometrial polyps, 27 (4.59%) had endometrial cancer, 11 (1.87%) had chronic endometritis, nine (1.53%) had simple cystic hyperplasia.
Conclusion: Leiomyoma and adenomyosis were the most common benign lesions. The peak incidence was in 31-40 years age group. These two lesions most frequently occured together. Histopathology is mandatory for confirming diagnosis. Routinely done ultrasound examination of gynecological patients is not enough for confirmation of adenomyosis.

Key words: Histopathology, hysterectomy, Leiomyomas, adenomyosis, ovarian cyst.