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Adenomyosis- Pathogenesis
Presence of endometrial glands and stroma deep within the myometrium (>2.5 mm from EJZ)
• TRAUMA
IATROGENIC: D&C / C-SECTION
UTERINE SURGERY
• UTERINE PATHOLOGY
Different definitions of adenomyosis used in literature
Reference
Novak and Woodruff 1979
Parazini et al 1997
Zaloudek and Hendrikkson 2002
Gompel and Silverberg 1985
Owolabi and Strickler (1980
Hendrickson and Kempson (1980)
Shalk and Khan(1990)
Bergholt et al (2001)
Levgur et al (2000)
Depht from endometrial-myometrial junction
> One high power field
>0.5 of low-power field about 2.5 mm
one medium-power field ((x100 lens)
> Low power field
One fourth the total thickness of the uterine wall away from the deepest point of the apparently normal endometrial-myometrial intersection. We are oath to make a diagnosis of adenomyosis in the premenopausal uterus unless there is associated smooth muscle hypertrophia
Fenestration of more than one third to one fourth of the total thickness of the uterine wall bellow the E-M junction
Variuous analysis >&, >3 or > 5 mm, but recommended 3 mm as cut-off
Depth of 2.5 mm or more
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