On T2-weighted MRI, a woman with heavy menstrual bleeding shows diffuse junctional zone thickening with small high signal intensity foci scattered within the myometrium. This appearance corresponds to which pathological finding?
- A Dilated lymphatic channels of lymphangitic carcinomatosis
- B Necrotic foci within a leiomyoma
- C Cystically dilated ectopic endometrial glands and haemorrhage within heterotopic islands ✓
- D Adenomyomatous polyp protruding into the cavity
Correct answer: C. Cystically dilated ectopic endometrial glands and haemorrhage within heterotopic islands
Explanation
The bright foci on T2-weighted images within a thickened junctional zone represent cystically dilated heterotopic endometrial glands, often containing haemorrhagic fluid that may also appear bright on T1. This moth-eaten appearance is highly suggestive of adenomyosis. Leiomyomas show well-defined rounded lesions rather than diffuse junctional change. Adenomyomatous polyp is a focal entity distinct from diffuse adenomyosis and would project into the endometrial cavity.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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