Endometrial changes associated with myomata of the uterus

The endometrium of 30 uteruses with myomata was studied at four standard sites. Glandular atrophy over a myoma or opposite a myoma was the most constant finding. At the margin of a myoma hyperplastic glands were frequently found, and distorted, elongated, or dilated glands were present at this site in half of all specimens. Other changes included adenomyosis and the separation of glands by muscle fibres from the basal layer of the endometrium. The coexistence of many of these findings in endometrial curettings can lead to the histological diagnosis of uterine myomata. Two factors, mechanical and hormonal, may be responsible and their mechanisms are discussed.