Adenomyosis with tuberculosis of uterus.

Adenomyosis refers to the presence of islands of endometrial glands and stroma within the myometrium. The glands may even reach the serosal surface of the uterus. Benson Smeeden established the criterian for adenomyosis that the endometrial glands should extend at least two low power fields into the myometrium. It occurs in 8% to 27% of patients and is usually encountered in women over 35 years age. Adenomyosis results in an enlarged and globular uterus because of myometrial hypertrophy. The diagnosis may be suspected on cut sections in the presence of depressed small cystic lesions in obvious but ill defined zones of muscle hypertrophy. Microscopically the endometrium of adenomyosis usually has a proliferative appearnce, consistent with its basal aver derivation. When the endometriurn is in the secretory phase. this is true only in one quarter of foci of adenomyosis. These foci can be involved by any of the diseases affecting the orthotopic endornetrium, including hyperplasia and adenocarcinoma. Tuberculosis of female genital tract is common amongst all communities where pulmonary or other forms of extra genital tuberculosis is prevalent. It follows that genital tract tuberculosis is nearly always secondary to a focus elsewhere in the body but the spread takes place at a very early stage of disease.