The Pathology of Adenomyosis

Fang Xiao, Min Xue
In: Adenomyosis · 2021 · pp. 21–26 · doi:10.1007/978-981-33-4095-4_3 · W3130654625
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Adenomyosis is characterized by endometrial glands and stroma within the myometrium, accompanied by smooth muscle hyperplasia, though its exact pathogenesis remains unclear despite multiple theories.

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This chapter reviews the pathology and proposed pathogenesis of adenomyosis, defining it as benign penetration of endometrium into the uterine myometrium with characteristic endometrial glands and interstitial cell islands plus hyperplasia and hypertrophy of surrounding smooth muscle. It cites Cullen’s 1908 analysis of 73 consecutive cases, in which 56 were connected to the endometrium, supporting the commonly accepted idea that adenomyosis arises from endometrial glands and stroma. Although trauma to the endometrium lining is described as conducive to invasion, the chapter notes that a clear explanation is lacking for cases occurring without prior uterine surgery, and it states that why invasion occurs remains unclear with multiple theories referenced in prior material. Relevance to endometriosis: it discusses shared pathogenetic concepts and explicitly references the “pathogenetic role of stromal cells in endometriosis and adenomyosis,” though the chapter’s main focus is adenomyosis pathology.

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Abstract

Adenomyosis is a benign penetration of the endometrium into the muscle layer of the uterus. Characteristically, there are endometrial glands and interstitial cell islands in the myometrium, accompanied by hyperplasia and hypertrophy of the surrounding smooth muscle tissue. Cullen in 1908 [1] studied 73 consecutive cases of adenomyosis; 56 cases were found to be connected to the endometrium, so it is generally accepted that adenomyosis comes from the endometrial glands and stroma. Although trauma to the endometrium lining is conducive to the invasion of the glands into the myometrium, to form the adenomyosis, it is difficult to explain why adenomyosis occurs in women who have not had uterine surgery, such as uterine curetting or myomectomy. The reason why the endometrial glands invade the myometrium remains unclear; various theories of its pathogenesis have been mentioned in the previous chapter. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Cullen TS. Adenomyoma of the uterus. J Am Med Assoc. 1908;50(2):107–15. Mai K, et al. Pathogenetic role of the stromal cells in endometriosis and adenomyosis. Histopathology. 1997;30(5):430–42. Chawla N, et al. Salpingitis isthmica nodosa. Indian J Pathol Microbiol. 2009;52(3):434. Zhang Bin LA-d, Xiangmei Z. Clinico-pathological analysis of 215 patients with adenomyosis. Fujian Med J. 2010;32(1):76–7. Colman HI, Rosenthal AH. Carcinoma developing in areas of adenomyosis. Obstet Gynecol. 1959;14(3):342–8. Sampson JA. Endometrial carcinoma of the ovary, arising in endometrial tissue in that organ. Arch Surg. 1925;10(1):1–72. Gitlin MJ, Pasnau RO. Psychiatric syndromes linked to reproductive function in women: a review of current knowledge. Am J Psychiatry. 1989;146(11):1413–22. Yang Zhu CY, Lina H, Zhixuan W (2003) The preliminary study of pathological changes of adenomyosis in human body after high-intensity focused ultrasound therapy clinical ultrasound Medicine Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. About this chapter Cite this chapter Xiao, F., Xue, M. (2021). The Pathology of Adenomyosis. In: Xue, M., Leng, J., Wong, F. (eds) Adenomyosis. Springer, Singapore. https://doi.org/10.1007/978-981-33-4095-4_3 Download citation DOI: https://doi.org/10.1007/978-981-33-4095-4_3 Published: Publisher Name: Springer, Singapore Print ISBN: 978-981-33-4094-7 Online ISBN: 978-981-33-4095-4 eBook Packages: MedicineMedicine (R0)

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