Examination of leiomyoma nodes (conservative myomectomy)

Histological examination of leiomyoma nodes — is a pathomorphological analysis of uterine tumors removed during organ-preserving surgery (myomectomy). Unlike complete removal of the uterus, conservative myomectomy allows for the preservation of the organ and reproductive function, and histology confirms the benignity of the removed nodes.

Research objective: The main task is to morphologically confirm the diagnosis of leiomyoma and exclude rare but aggressive malignant tumors - leiomyosarcomas. The analysis also helps to assess the growth rate of the tumor and its structure, which is important for predicting possible recurrences.

What does the pathologist evaluate:

• Leiomyoma type: determination of the tumor variant (conventional, cellular, mitotically active, lipoleiomyoma, etc.).

• Signs of degeneration: detection of edema, necrosis, hyalinosis, or cystic changes within the node, often accompanied by pain.

• Cellular activity: counting the number of cell divisions (mitoses) to assess the tumor's growth potential.

• Vascular network: the state of the blood supply to the nodes, which may affect the risk of their recurrence.

Clinical significance: The result of the study is crucial for the patient's further rehabilitation, especially if she is planning a pregnancy. Confirmation of the benign nature of the nodes allows the doctor to provide recommendations on the timing of conception and the tactics of managing a future pregnancy (taking into account the presence of a scar on the uterus).

When is it prescribed:

• after surgery to remove myomatous nodes (laparoscopic or laparotomic myomectomy);

• rapid growth of nodes according to ultrasound data;

• the presence of atypical signs of the tumor on magnetic resonance imaging (MRI);

• preparation for pregnancy after surgical treatment of fibroids.