BACKGROUND The most commonly done gynaecological surgery worldwide is hysterectomy. Myometrial lesions contribute to majority of cases with abnormal uterine bleeding. Leiomyoma and adenomyosis are most common lesions seen in the myometrium. The present study was undertaken to identify the various types of myometrial pathologies in hysterectomy samples. METHODS This is a two-year retrospective cross-sectional study done from January 2017 to December 2018, in the Department of Pathology, Kodagu

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... stitute of Medical Sciences, Madikeri. All the patients who underwent hysterectomy and myomectomy for myometrial lesions of uterus were included in the study. Hysterectomy specimens showing secondaries, gross infection, massive haemorrhage and necrosis were excluded from the study. Gross appearance and microscopic pathology were noted and results were analysed. RESULTS In this study, 148 specimens were included. Age range was from 20 years to 65 years. Histopathological examination revealed that 58.25 % of myometrial lesions were present in the age group of 41 to 50 years followed by age group of 31 to 40 years. Histopathological examination done showed the following diagnosis in patients - leiomyoma (85.13 %), adenomyosis (8.79 %) and leiomyoma with adenomyosis (6.08 %). CONCLUSIONS The commonest histopathological lesion in myometrium was leiomyoma (85.13 %) followed by adenomyosis (8.79 %). It is mandatory to examine the hysterectomy specimens adequately to diagnose myometrial lesions.