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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]] | ||