Endometriosis

<bold>FIGURE 2.17 A, B:</bold> Close-up view of adenomyosis of the uterine fundus. This is diverticulosis of the uterine wall (<italic>arrows</bold> point to diverticular holes). <italic>V</bold> points to enlarged vessels. <bold>C:</bold> Associated with diverticular adenomyosis are enlarged, thin-walled surface vessels that account for increased uterine bleeding at the time of menses.

<bold>FIGURE 5.3</bold> Adenomyosis, foci of endometrial glands and stroma deep within the myometrium, distort the uterine wall. (10×, hematoxylin and eosin.)

<bold>FIGURE 5.4</bold> This gross photograph of a bisected supracervical hysterectomy specimen exhibits irregular thickening of the myometrium, characteristic of adenomyosis. Multiple deep myometrial foci of dark blue discoloration mark the sites of adenomyosis (<italic>long white arrows</bold>). The short black arrow indicates a small leiomyoma.

<bold>FIGURE 18.27</bold><bold>A</bold> and <bold>B:</bold> Hysterograms show direct signs of adenomyosis. The contrast medium has injected numerous diverticula.

<bold>FIGURE 22.40</bold> A: Endometrial atrophy with adhesions at the fundus of the uterus and old adenomyosis. B: Large diverticulum of adenomyosis just below the uterine fundus.

<bold>FIG. 28.8.</bold>Pelvic pain. A: Composite transvaginal sonogram showing enlarged left ovary (top right and bottom left) without flow and associated with a paraovarian cyst in left adnexa (lower right). The right ovary (top left) was normal, showing intraparenchymal flow. The left adnexa was found to be twisted three times and was surgically untwisted with good result. See color figure 28.8A. B: Doppler sonogram of enlarged left ovary containing venous flow. This finding suggest...

<bold>Fig GU 41-4. Diffuse uterine adenomyosis.</bold> Sagittal T2-weighted image demonstrates an enlarged uterus with thickening of the myometrium and diffuse low signal intensity throughout. The junctional zone is obliterated.⁴⁴

Clinical features of endometriosis. End = endometriosis; A = uterosacral implants.

Charles RB Beckmann, Frank  W, etal. Obstetrics and Gynecology, Fifth Edition. Philadelphia: Lippincott Williams & Wilkins, 2006

Pelvic endometriosis

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Pelvic endometriosis.

Berek  JS. Berek & Novak's Gynecology, 15th Edition. Philadelphia: Lippincott Williams & Wilkins, 2012.

Endometriosis of the bladder. A section of the bladder wall shows endometrial glands and stroma, with a focus of hemorrhage.

Adenomyosis. A microscopic view shows an endometrial gland and stroma in the myometrium.

Sites of endometriosis.

Endometriosis. Implants of endometriosis on the ovary appear as red-blue nodules.

FIG. 3.81. Diffuse adenomyosis. Sagittal T2-weighted image through uterus demonstrates thickened, indistinct junctional zone (<italic>arrows</bold>).

Typical and subtle endometriotic lesions on peritoneum. A: Typical blackpuckered lesions with hypervascularization and orange polypoid vesicles. B: Red polypoid lesions with hypervascularization. (Photographs from Dr. Christel Meuleman, Leuven University Fertility Center, Leuven University Hospitals, Leuven, Belgium.)