Endometrial Tissue in Myometrial Vessels not Associated with Menstruation

Sahin AA, Aysegul A. Sahin, A A Sahin, Silva EG, E. G. Silva, Elvio G. Silva, Landon G, Gene Landon, G Landon, Nelson G. Ordoñez, N G Ordonez, Ordonez NG, David M. Gershenson, Gershenson DM, D. M. Gershenson
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 1989 · vol. 8(2) , pp. 139–146 · doi:10.1097/00004347-198906000-00007 · PMID:2469659 · W1982845386
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Endometrial tissue within myometrial vessels was observed in 14 women with extensive adenomyosis, suggesting a possible origin from perivascular cells rather than menstruation.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-20 · read from full text ⓘ

This study examined 277 hysterectomy specimens to determine if endometrial tissue found in myometrial vessels is linked to menstruation, specifically focusing on nonmenstruating women. The researchers identified intravascular endometrial tissue in only 14 cases, all of which exhibited extensive adenomyosis, while no such tissue was present in uteri lacking this condition. The authors propose that uncommitted perivascular cells may proliferate and enter intact vascular lumina, suggesting a mechanism independent of menstrual flow that pathologists must recognize to avoid misdiagnosing the findings as neoplastic. This paper is centrally about adenomyosis — specifically investigating the histological relationship between adenomyotic foci and intravascular endometrial tissue.

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Abstract

The presence of endometrial tissue in myometrial vessels has been described in the literature primarily in association with the menstrual period. We reviewed 277 hysterectomy specimens to assess the frequency of endometrial tissue in myometrial vessels in the uteri of nonmenstruating women. Intravascular endometrial tissue was observed in 14 cases, all of which showed extensive adenomyosis usually present in multiple foci. None of the uteri without adenomyosis showed intravascular endometrial tissue. In foci of adenomyosis, the intimate relationship of endometrial tissue and vessels might be explained by the possible origin of endometrial tissue from uncommitted perivascular cells, a possibility that is supported by our failure to demonstrate a connection between the foci of adenomyosis and endometrium in serial sections. When the uncommitted perivascular cells proliferate, they may impinge on endothelially intact vascular lumina and later become intraluminal. Pathologists should be aware of this phenomenon associated with adenomyosis to avoid interpreting the cells within vessels as being neoplastic.
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Endometrial Tissue in Myometrial Vessels not Associated with Menstruation - Aysegul A. Sahin - Elvio G. Silva - Gene Landon - Nelson G. Ordonez - David M. Gershenson Summary: The presence of endometrial tissue in myometrial vessels has been described in the literature primarily in association with the menstrual period. We reviewed 277 hysterectomy specimens to assess the frequency of endometrial tissue in myometrial vessels in the uteri of nonmenstruating women. Intravascular endometrial tissue was observed in 14 cases, all of which showed extensive adenomyosis usually present in multiple foci. None of the uteri without adenomyosis showed intravascular endometrial tissue. In foci of adenomyosis, the intimate relationship of endometrial tissue and vessels might be explained by the possible origin of endometrial tissue from uncommitted perivascular cells, a possibility that is supported by our failure to demonstrate a connection between the foci of adenomyosis and endometrium in serial sections. When the uncommitted perivascular cells proliferate, they may impinge on endothelially intact vascular lumina and later become intraluminal. Pathologists should be aware of this phenomenon associated with adenomyosis to avoid interpreting the cells within vessels as being neoplastic.

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Condition tags

adenomyosis

MeSH descriptors

Endometrium Menstruation Myometrium Endometrium Female Humans Myometrium Myometrium Staining and Labeling

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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