Background: Leiomyoma which is the commonest visceral neoplasm affecting females in reproductive age group has many secondary changes as well as recognized histological variants,some of which pose diagnostic problems in differentiating from malignant neoplasms like leiomyosarcoma. Intravascular leiomyoma, a rare variant though benign in nature, has a metastatic potential because of vascular invasion. Aim: The present study is undertaken, to study and analyze various histopathological changes within uterine leiomyomas. Methods and material: The study included all leiomyoma cases received over a period of 2 years. After taking relevant clinical data, a proper gross examination was done before the representative areas were sectioned, processed, stained and studied in detail under a light microscope. Clinical, gross and histological features were corelated. Results: A total of 348 specimens were received. multiparous women were the most effected with a peak incidence in the 4th decade of life. Menorrhagia was the most common presentation and the most common location was intramural. Degenerative changes were observed in 48.27% cases, amongst which hyaline change was the most common. The histologic variants which posed diagnostic difficulties were Cellular leiomyoma, Atypical Leiomyoma and Intravascular leiomyoma. Conclusion: Uterine Leiomyomas are common benign tumors followed by their changes and variants, which can create diagnostic problems especially those with increased mitosis, cellularity and nuclear atypia.

Keywords: Leiomyoma; Variants; Changes.