Mikroskopischer und ultra-mikroskopischer Nachweis von Mikrotraumen in der Endometrialen-Myometrialen Übergangzone von Adenomyose-Patientinnen

This study prospectively compared uterine tissue from 25 premenopausal patients with histologically confirmed adenomyosis (n=11) versus controls without adenomyosis (n=14), using laparoscopy-assisted vaginal hysterectomy specimens sampled from the endometrial–myometrial junction zone. The authors examined microtrauma-related changes using immunohistochemistry for α-smooth muscle actin (ASMA) and collagen I, van Gieson staining for collagen fiber orientation, and transmission electron microscopy, focusing on the junctional region implicated by the TIAR theory. They found stronger ASMA expression in stromal cells and higher collagen I expression in the inner myometrium in the adenomyosis group, alongside ultrastructural evidence of irregular nuclear membranes in epithelial cells and a disrupted (crenellated) junctional zone, whereas controls showed smoother junctional architecture. A limitation stated in the framing is that the sampling targets the TIAR-relevant zone but the findings are observational at the tissue level. This paper is centrally about endometriosis and adenomyosis — specifically adenomyosis, with microscopic and ultrastructural demonstration of microtrauma in the endometrial–myometrial transition zone.

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