Uterine adenomyosis

Uterine adenomyosis, also adenomyosis of the uterus, is a relatively common benign pathology of the uterine corpus. It can be thought of as endometriosis in the uterine smooth muscle.

Uterine adenomyoma redirects here.

General

• Common.
• May be a cause of bleeding.
• Dysmenorrhea - painful menses.
• Associated with endometriosis.^{[citation needed]}

Gross

Features:

• Trabeculated cut surface +/- small foci of hemorrhage.
  • Often described as "basket-weave" pattern.
• Globoid, slightly enlarged.

Note:

• May form a mass - known as adenomyoma.

Image:

• Uterine adenomyosis (flickr.com/infopathic).
• Uterine adenomyosis - close-up (flickr.com/infopathic).

Microscopic

Features:

• Endometrial glands within uterine muscle - key feature.
  • Endometrial glands:
    • Circular.
    • Simple epithelial or pseudostratified epithelium +/- mitoses.
  • +/-Surrounded by endometrial stroma.
    • Densely packed spindle cells without nuclear atypia.
  • Blood:
    • Within glands.
    • Hemosiderin-laden macrophages.

Note:

• Can be thought of as endometriosis of the myometrium.

DDx:

• Endometrioid endometrial carcinoma.

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UTERUS, UTERINE CERVIX, TOTAL HYSTERECTOMY:
- UTERUS WITH ADENOMYOSIS.
- UTERINE CERVIX WITHIN NORMAL LIMITS.
- PROLIFERATIVE PHASE ENDOMETRIUM.

UTERUS, UTERINE CERVIX, TOTAL HYSTERECTOMY:
- UTERUS WITH SUPERFICIAL ADENOMYOSIS.
- UTERINE CERVIX WITH PARTIAL DENUDATION, FOCUS OF ENDOMETRIOSIS AND INFLAMMATION,
  OTHERWISE WITHIN NORMAL LIMITS.
- SUPERFICIAL FIBROSIS AND HYALINE CHANGE OF THE UTERINE LINING -- COMPATIBLE
  WITH PRIOR ABLATION.

See also

• Uterus.
• Adenomyosis.