On histology, adenomyosis is defined by endometrial glands and stroma within the myometrium. The minimum depth required from the endometrial-myometrial junction (EMJ) for histological diagnosis of adenomyosis is:

• A One HPF (high power field) depth below the EMJ
• B More than one low-power field (5 mm from EMJ) below the EMJ — the Benson criteria
• C More than one half of a low-power field (2.5 mm from EMJ) below the EMJ ✓
• D Any gland within the myometrium, regardless of depth

Explanation

The histological criterion for adenomyosis requires endometrial glands and stroma located more than one low-power microscopic field (approximately 2.5 mm from the basalis) below the endomyometrial junction. This is the widely accepted threshold to distinguish adenomyosis from infolding artefact or junctional zone irregularity. The Benson and Sneeden criteria (1958) defined > 2.5 mm as the minimum depth, though some authorities use > 1 HPF below the EMJ, both refer to approximately the same practical depth.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.