The myometrium

Published online by Cambridge University Press: 05 July 2014 Non-neoplastic conditions of the myometrium ADENOMYOSIS Adenomyosis is characterised by the presence of endometrial tissue deep within the myometrium and there is almost invariably an associated hypertrophy of smooth muscle around the ectopic islands of endometrium. The foci of endometrial tissue may be distributed diffusely within the myometrium, in which case the uterus shows a roughly symmetrical enlargement, or can be focal, forming a poorly-defined tumour-like asymmetrical thickening of the myometrium (Figure 5.1). The localised form is often known as an ‘adenomyoma’, an unfortunate term because of its misleading connotation of neoplasia. Histologically, foci of adenomyosis consist of both endometrial glands and stroma (Figure 5.2). The glands are usually of basal type and thus do not show cyclic activity. Adenomyosis is caused by a downgrowth of basal endometrium into the myometrium. Serial sectioning shows continuity between the basal endometrium and foci of adenomyosis. The aetiology of this diverticular disease is, however, obscure, for although both curettage and estrogenic stimulation have been proposed as aetiological factors, there is no proof that either is of causal significance. VASCULITIS The majority of cases of vasculitis of the myometrium are isolated lesions, particularly when they affect only the small vessels. Occasionally, however, larger arteries are affected and the possibility of there being a systemic arteritis should be considered. INFLAMMATION Infection in the endometrium may spread to the myometrium following childbirth, miscarriage or intrauterine surgery. On rare occasions, however, non-infective inflammation may develop in systemic disease, such as sarcoidosis (Figure 5.3). - Type - Chapter - Information - Publisher: Cambridge University PressPrint publication year: 2009 Accessibility compliance for the PDF of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - The myometrium - Book: Gynaecological and Obstetric Pathology for the MRCOG and Beyond - Online publication: 05 July 2014 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - The myometrium - Book: Gynaecological and Obstetric Pathology for the MRCOG and Beyond - Online publication: 05 July 2014 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - The myometrium - Book: Gynaecological and Obstetric Pathology for the MRCOG and Beyond - Online publication: 05 July 2014