A 38-year-old multiparous woman has progressively heavy and painful menstrual periods. The uterus is symmetrically enlarged, globular, and boggy. Hysterectomy shows thickened myometrium containing irregular nests of endometrial glands and stroma deep within hypertrophic smooth muscle. What is the diagnosis?
- A Intramural leiomyoma
- B Adenomyosis ✓
- C Endometrial stromal sarcoma
- D Submucosal endometrial polyp
Correct answer: B. Adenomyosis
Explanation
Adenomyosis is the presence of endometrial glands and stroma within the myometrium, typically in multiparous women in their late reproductive years, causing menorrhagia and dysmenorrhea with a boggy, globular uterus. Leiomyomas form discrete, well-circumscribed whorled masses rather than diffuse myometrial thickening with embedded glands, which is the finding that rules out option A here.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.