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Adenomyosis

Adenomyosis is characterized by the presence of endometrial glands and stroma in the myometrium and is often associated with local myometrial hypertrophy. Endometrial glands and stroma outside the uterus, or including the serosa but not the adenomyosis myometrium, are defined as endometriosis

Histogenesis and Pathology

The most popular theory of the histogenesis of adenomyosis is that the basoendometrium invades the myometrium to give rise to foci of adenomyosis. Uterine trauma at the time of delivery, increased uterine pressure, or chronic endometritis may contribute to this invasion. Alternatively, preliminary evidence suggests that some lesions may be monoclonal and can exhibit the cytogenetic abnormalities seen in myomata. If adenomyosis proves to be clonal, then adenomiosis

The normal endomyometrial junction is irregular, with endometrial glands and stroma dipping into the myometrium for a variable distance. Many pathologists define adenomyosis as the presence of endometrial glands and stroma in the myometrium more adenomyosis than 2-3 mm below the endomyometrial junction. The pathologic diagnosis of adenomyosis is adenomyosis highly dependent on the number of sections from the uterine specimen that are processed for analysis. In one study of 200 consecutive hysterectomy specimens, the investigators observed that if three routine sections of myometrium were taken for analysis, 62 women (31%) had a diagnosis of adenomyosis. If an additional six adenomyosis myometrial sections were taken, 61 additional cases of adenomyosis were discovered, resulting in 62% of the specimens revealing adenomyosis. Autopsy studies on women of reproductive, adnomyosis, adnomiosis...

       

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