Diffuse myometrial sclerosis. Its nature and its association with endometrial hyperplasia, adenomyosis, pelvic endometriosis, and leiomyomas.

Abstract The condition which has been variously termed “fibrosis uteri”, “hypertrophy of the uterus”, “chronic metritis”, “subivolution”, “myometrial hypertrophy”, and “benign enlargement” is a definite clinical and pathologic entity which has long deserved a more clear-cut definition. The clinical manifestations are varied and at times vague, but the author presents data to establish that the process can be defined in the surgical pathology laboratory and that in a high percentage of cases it is accompanied by leiomyomas, adenomyosis, pelvic endometriosis, and endometrial hyperplasia either alone or in varying combinations. The study is based on a series of 564 consecutive uteri received in one surgical pathology laboratory in which the diagnosis of myometrial sclerosis was made 139 times. Only in 41 of these cases was the “diffuse myometrial sclerosis” an isolated finding. The author establishes that the main condition described is always accompanied by a symmetrical increase in volume of the uterine wall and that this is due principally to a corresponding increase in fibrous tissue in the stroma.