A 42-year-old woman with known adenomyosis presents with progressive secondary dysmenorrhea. Which of the following best describes the characteristic histopathological feature of adenomyosis?
- A Ectopic endometrial glands and stroma within the myometrium, at least one low-power field from the basalis layer ✓
- B Smooth muscle bundles arranged in whorled pattern with no intervening endometrium
- C Chronic inflammatory infiltrate surrounding thick-walled blood vessels in the myometrium
- D Hemorrhagic cystic spaces lined by hemosiderin-laden macrophages in the superficial myometrium
Correct answer: A. Ectopic endometrial glands and stroma within the myometrium, at least one low-power field from the basalis layer
Explanation
Adenomyosis is defined by the presence of ectopic endometrial glands and stroma within the myometrium. The diagnostic criterion requires the tissue to be at least one low-power field (approximately 2.5 mm or one high-power field, depending on the textbook) away from the basalis layer of the endometrium. Option B describes a normal leiomyoma. Option D more closely describes the appearance of endometriosis with hemosiderin-laden macrophages, not adenomyosis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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