Difference between revisions of "Uterine adenomyosis"
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'''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.<ref>{{Cite journal | last1 = Reinhold | first1 = C. | last2 = Tafazoli | first2 = F. | last3 = Mehio | first3 = A. | last4 = Wang | first4 = L. | last5 = Atri | first5 = M. | last6 = Siegelman | first6 = ES. | last7 = Rohoman | first7 = L. | title = Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. | journal = Radiographics | volume = 19 Spec No | issue = | pages = S147-60 | month = Oct | year = 1999 | doi = | PMID = 10517451 | URL = http://radiographics.rsna.org/content/19/suppl_1/S147.full }}</ref> | |||
*Dysmenorrhea - painful menses.<ref name=pmid22594861>{{Cite journal | last1 = Cockerham | first1 = AZ. | title = Adenomyosis: a challenge in clinical gynecology. | journal = J Midwifery Womens Health | volume = 57 | issue = 3 | pages = 212-20 | month = | year = | doi = 10.1111/j.1542-2011.2011.00117.x | PMID = 22594861 }}</ref> | |||
*Associated with [[endometriosis]].{{fact}} | |||
==Gross== | |||
Features: | |||
*Trabeculated cut surface +/- small foci of hemorrhage.<ref name=Ref_Lester3_432>{{Ref Lester3|432}}</ref> | |||
**Often described as "basket-weave" pattern. | |||
*Globoid, slightly enlarged.<ref name=pmid20291238>{{Cite journal | last1 = HUNTER | first1 = WC. | last2 = SMITH | first2 = LL. | last3 = REINER | first3 = WC. | title = Uterine adenomyosis; incidence, symptoms, and pathology in 1,856 hysterectomies. | journal = Am J Obstet Gynecol | volume = 53 | issue = 4 | pages = 663-8 | month = Apr | year = 1947 | doi = | PMID = 20291238 | URL = http://journals.lww.com/obgynsurvey/Citation/1947/10000/The_Uterus__Uterine_Adenomyosis__Incidence,.61.aspx }}</ref> | |||
Note: | |||
*May form a mass - known as ''[[adenomyoma]]''.<ref name=pmid16990713>{{Cite journal | last1 = Tahlan | first1 = A. | last2 = Nanda | first2 = A. | last3 = Mohan | first3 = H. | title = Uterine adenomyoma: a clinicopathologic review of 26 cases and a review of the literature. | journal = Int J Gynecol Pathol | volume = 25 | issue = 4 | pages = 361-5 | month = Oct | year = 2006 | doi = 10.1097/01.pgp.0000209570.08716.b3 | PMID = 16990713 }} | |||
</ref> | |||
Image: | |||
*[http://www.flickr.com/photos/34342634@N02/5036818444/ Uterine adenomyosis (flickr.com/infopathic)]. | |||
*[http://www.flickr.com/photos/34342634@N02/5036818516/ 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]]. | |||
==Sign out== | |||
<pre> | |||
UTERUS, UTERINE CERVIX, TOTAL HYSTERECTOMY: | |||
- UTERUS WITH ADENOMYOSIS. | |||
- UTERINE CERVIX WITHIN NORMAL LIMITS. | |||
- PROLIFERATIVE PHASE ENDOMETRIUM. | |||
</pre> | |||
<pre> | |||
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. | |||
</pre> | |||
==See also== | |||
*[[Uterus]]. | |||
*[[Adenomyosis]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Uterus]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
Revision as of 03:15, 7 March 2014
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.[1]
- Dysmenorrhea - painful menses.[2]
- Associated with endometriosis.[citation needed]
Gross
Features:
- Trabeculated cut surface +/- small foci of hemorrhage.[3]
- Often described as "basket-weave" pattern.
- Globoid, slightly enlarged.[4]
Note:
- May form a mass - known as adenomyoma.[5]
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.
- Endometrial glands:
Note:
- Can be thought of as endometriosis of the myometrium.
DDx:
Sign out
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
References
- ↑ Reinhold, C.; Tafazoli, F.; Mehio, A.; Wang, L.; Atri, M.; Siegelman, ES.; Rohoman, L. (Oct 1999). "Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation.". Radiographics 19 Spec No: S147-60. PMID 10517451.
- ↑ Cockerham, AZ.. "Adenomyosis: a challenge in clinical gynecology.". J Midwifery Womens Health 57 (3): 212-20. doi:10.1111/j.1542-2011.2011.00117.x. PMID 22594861.
- ↑ Lester, Susan Carole (2010). Manual of Surgical Pathology (3rd ed.). Saunders. pp. 432. ISBN 978-0-323-06516-0.
- ↑ HUNTER, WC.; SMITH, LL.; REINER, WC. (Apr 1947). "Uterine adenomyosis; incidence, symptoms, and pathology in 1,856 hysterectomies.". Am J Obstet Gynecol 53 (4): 663-8. PMID 20291238.
- ↑ Tahlan, A.; Nanda, A.; Mohan, H. (Oct 2006). "Uterine adenomyoma: a clinicopathologic review of 26 cases and a review of the literature.". Int J Gynecol Pathol 25 (4): 361-5. doi:10.1097/01.pgp.0000209570.08716.b3. PMID 16990713.