Pathomorphological Analysis of Internal Endometriosis

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This study examined 59 women with internal endometriosis, finding it more frequent in perimenopause and associated with uterine leiomyomas, endometrial hyperplasia, and ovarian changes, with two identified morphological variants of adenomyosis.

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Abstract

We performed clinical and morphological examination of 59 women with internal endometriosis (adenomyosis). Women were found to develop adenomyosis more frequently in the perimenopausal period (in their 40s) after repeated abortions and diagnostic surgical procedures. In 90% patients, adenomyosis was associated with the formation of multiple leyomyomatous nodules; glandular hyperplasia of the endometrium and fibrocystic transformation or fibrous degeneration of the ovaries were found in 60 and 100% cases. Two morphological variants of adenomyosis were identified: invasion of cytogenic stroma into the underlying myometrium with the formation of endometrial glands and invasion of cytogenic stroma via connective tissue interlayers without formation of endometrial glands and with pronounced neoangiogenesis. Foci of active adenomyosis in the uterus with predominance of cytogenic stroma were most prevalent in the late reproductive period. Endometrioid heterotopias were accompanied by considerable structural and functional reorganization of the myometrium with the formation of multiple leyomyomatous nodules. The presence of active and inactive adenomyosis foci and leyomyomatous nodules in uterus specimens reflects their metachronous development.
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We performed clinical and morphological examination of 59 women with internal endometriosis (adenomyosis). Women were found to develop adenomyosis more frequently in the perimenopausal period (in their 40s) after repeated abortions and diagnostic surgical procedures. In 90 % patients, adenomyosis was associated with the formation of multiple leyomyomatous nodules; glandular hyperplasia of the endometrium and fibrocystic transformation or fibrous degeneration of the ovaries were found in 60 and 100 % cases. Two morphological variants of adenomyosis were identified: invasion of cytogenic stroma into the underlying myometrium with the formation of endometrial glands and invasion of cytogenic stroma via connective tissue interlayers without formation of endometrial glands and with pronounced neoangiogenesis. Foci of active adenomyosis in the uterus with predominance of cytogenic stroma were most prevalent in the late reproductive period. Endometrioid heterotopias were accompanied by considerable structural and functional reorganization of the myometrium with the formation of multiple leyomyomatous nodules. The presence of active and inactive adenomyosis foci and leyomyomatous nodules in uterus specimens refl ects their metachronous development. Similar content being viewed by others References L. V. Adamian, V. I. Kulakov, and E. N. Andreyeva, Endometriosis. Guidelines for Physicians [in Russian], Мoscow (2006). N. M. Anichkov and V. A. Pechenikova, Arch. Patol., No. 3, 31-34 (2005). N. M. Anichkov, V. A. Pechenikova, and D. F. Kostyuchek, Arch. Patol., No. 4, 5-10 (2011). I. N. Voloshchuk, Y. A. Romadanova, A. I. Ishchenko, and A. A. Bakhvalova, Arch. Patol., No. 3, 56-60 (2007). Y. V. Gorbacheva, Y. A. Romadanova, M. A. Solomakhina, et al., Arch. Patol., No. 5, 12-16 (2008). O. V. Zayratyants, L. V. Adamian, E. N. Andreyeva, et al., Arch. Patol., No. 5, 6-12 (2010). O. V. Zayratyants, L. V. Adamian, M. M. Sonova, et al., Arch. Patol., No. 5, 16-19 (2008). A. I. Ishchenko, E. A. Kudrina, I. V. Stanojevic, et al., Akush. i Ginekol., No. 5, 67-73 (2007). E. A. Kogan, N. V. Nizyaeva, T. A. Demura, et al., Arch. Patol, No. 4, 7-12 (2010). E. A. Kogan, A. L. Unanian, T. A. Demura, et al., Arch. Patol., No. 5, 8-12 (2008). S. G. Morozov, A. V. Sorokina, and N. V. Zhilina, Akush. i Ginekol., No. 2, 15-17 (2010). V. A. Pechenikova, Arch. Patol., No. 4, 51-53 (2005). G. W. Montgomery, D. R. Nyholt, Z. Z. Zhao, et al., Hum. Reprod. Update, 14, No. 5, 447-457 (2008). M. Pitsos, N. Kanakas, Reprod. Sci., 16, No. 8, 717-728 (2009). O. Reich, S. Regauer, Curr. Opin. Oncol., 19, No. 4, 347-352 (2007). Author information Authors and Affiliations Corresponding author Additional information Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 153, No. 1, pp. 123-128, January, 2012 Rights and permissions About this article Cite this article Nepomnachhikh, L.M., Lushnikova, E.L., Pekarev, O.G. et al. Pathomorphological Analysis of Internal Endometriosis. Bull Exp Biol Med 153, 109–113 (2012). https://doi.org/10.1007/s10517-012-1657-0 Received: Published: Issue date: DOI: https://doi.org/10.1007/s10517-012-1657-0

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Condition tags

endometriosis

MeSH descriptors

Adenomyosis Endometrium Adenomyosis Adenomyosis Adult Aged Endometrium Female Humans Middle Aged

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