Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Non tumor


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 3 October 2011, last major update October 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.


● Endometrial glands and stroma deep in myometrium
● Causes menorrhagia, pelvic pain during menstruation; rarely causes rupture during pregnancy
● Occurs in 15% of uteri
● May be caused by tissue injury and repair (Arch Gynecol Obstet 2009;280:529)
● May be involved by hyperplasia or carcinoma


● To control symptoms: uterine artery embolization (Cardiovasc Intervent Radiol 2011 Aug 18 [Epub ahead of print]), D&C, hysterectomy

Gross description

● Numerous small cysts in enlarged and globular uterus, associated with myometrial hypertrophy and trabeculated smooth muscle
● Cannot be shelled out
● In elderly women, uterus may appear atrophic

Gross images

Thickened and spongy myometrium

Cystic cavities correspond to adenomyosis

Micro description

● Stroma plus marker glands deep in myometrium (at least one low power field from endomyometrial junction, which is usually irregular)
● Often smooth muscle hypertrophy present around glands
● Usually consists of basal layer of endometrium that may be connected with mucosa
● Usually proliferative endometrium, although only 25% is proliferative during secretory phase
● Microscopic foci may be in vascular spaces resembling endometrial stromal sarcoma
● May be difficult to distinguish carcinoma invading myometrium from carcinoma involving adenomyosis

Micro images

Various images

Differential diagnosis

Endometrial stromal sarcoma: no glandular tissue, invades myometrium in tongues, no muscular hypertrophy, unusual to contain diffuse small regular glands (Am J Clin Pathol 1995;103:218)

End of Uterus > Non tumor > Adenomyosis

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at [email protected] with any questions (click here for other contact information).