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Related Concept Videos

Histology of the Uterus01:19

Histology of the Uterus

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The uterine wall consists of three histological layers: the perimetrium, myometrium, and endometrium. The outermost perimetrium is a thin, serous membrane connected with the broad ligament on the sides, which helps anchor the uterus in the pelvic cavity. The thickest layer, myometrium, is mainly made up of smooth muscle tissue bundles. Its contractions are vital in facilitating the expulsion of the uterine lining, fetus, and placenta during menstruation and childbirth.
The endometrium is the...
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The proliferative phase typically occurs after menstruation and lasts between 6 to 13 days in a standard 28-day cycle. This phase involves the reconstruction of the endometrium, guided by estrogen produced by the developing ovarian follicle.
Notably, the stratum basale, the basal layer of the endometrium, including the basal parts of the uterine glands, remains unaffected by menstruation. Stem cells in this layer undergo mitosis, regenerating the stratum functionalis and thickening the...
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Classifying Adenomyosis: Progress and Challenges.

Marwan Habiba1,2, Giuseppe Benagiano3

  • 1Department of Health Sciences, University of Leicester, Leicester LE1 7HA, Leicestershire, UK.

International Journal of Environmental Research and Public Health
|December 10, 2021
PubMed
Summary
This summary is machine-generated.

Diagnosing adenomyosis (a uterine condition) faces challenges, particularly in histological interpretation and classification. Current research focuses on disease mapping using imaging to better understand adenomyosis extent and variants.

Keywords:
MRIadenomyosisclassificationendometriosisfibroidshistopathologyinner myometriumjunctional zoneouter myometriumultrasound

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Area of Science:

  • Gynecologic pathology and imaging diagnostics.
  • Reproductive medicine and surgical pathology.

Background:

  • Traditional adenomyosis diagnosis relied on post-hysterectomy histological examination, with classification based on endometrial invasion depth.
  • Histological diagnosis presents uncertainties regarding the precise cut-off for invasion.
  • Imaging modalities offer non-surgical diagnostic capabilities, assessing uterine and surrounding pelvic structures.

Purpose of the Study:

  • To explore diagnostic uncertainties in adenomyosis, including histological and imaging-based approaches.
  • To discuss the need for and challenges in developing a standardized classification system for adenomyosis.
  • To differentiate between disease mapping and a clinical-pathological classification.

Main Methods:

  • Review of current literature on adenomyosis diagnosis and classification.
  • Exploration of features relevant to taxonomy, including internal and external variants.
  • Analysis of uncertainties in classifying specific lesion locations (uterovesical pouch, pouch of Douglas, outer myometrium).

Main Results:

  • Imaging enables comprehensive assessment of adenomyosis extent and associated pelvic pathologies in non-surgical candidates.
  • Current evidence highlights significant challenges and uncertainties in establishing a definitive classification system.
  • The proposal for internal and external adenomyosis variants is discussed, alongside difficulties in classifying specific lesion sites.

Conclusions:

  • Agreement on a unifying hypothesis for adenomyosis classification remains elusive due to current evidence limitations.
  • Focus is currently directed towards 'disease mapping' for better understanding and reporting of adenomyosis lesions.
  • Development of an agreed system for reporting adenomyotic lesions is crucial for future research comparability and informed classification.