Pathomorphological Analysis of Internal Endometriosis

• Published in: Bulletin of experimental biology and medicine 2012-05, Vol.153 (1), p.109-113
• Main Authors: Nepomnachhikh, L. M., Lushnikova, E. L., Pekarev, O. G., Lushnikov, A. K., Nikitenko, E. V.
• Format: Article
• Language: English
• Subjects: Adenomyosis - diagnosis; Adenomyosis - pathology; Adult; Aged; Biomedical and Life Sciences; Biomedicine; Cell Biology; Endometriosis; Endometrium - pathology; Female; Humans; Internal Medicine; Laboratory Medicine; Menopause; Middle Aged; Ovarian cancer; Pathology
• ISSN: 0007-4888; 1573-8221
• DOI: 10.1007/s10517-012-1657-0

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.