{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:01:47Z","timestamp":1790690507854,"version":"4.1.0"},"reference-count":82,"publisher":"Georg Thieme Verlag KG","issue":"02\/03","funder":[{"name":"NIH","award":["RO1HD096147"],"award-info":[{"award-number":["RO1HD096147"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Reprod Med"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Adenomyosis represents a unique pathophysiological condition in which normal-appearing endometrial mucosa resides within myometrium and is thus protected from menstrual shedding. The resulting ectopic presence of endometrial tissue composed of glands and stroma is thought to affect normal contractile function and peristalsis of uterine smooth muscle, causing menometrorrhagia, infertility, and adverse obstetric outcomes. Since the first description of adenomyosis more than 150 years ago, pathologists have studied this lesion by examining tissue specimens, and have proposed multiple explanations to account for its pathogenesis. However, as compared with endometriosis, progress of adenomyosis research has been, at best, incremental mainly due to the lack of standardized protocols in sampling tissue and a lack of consensus diagnostic criteria in pathology practice. Despite these limitations, recent advances in revealing the detailed anatomy and biology of eutopic endometrium offer an unprecedented opportunity to study this common but relatively understudied disorder. Here, we briefly summarize the pathological aspects of adenomyosis from an historical background, and discuss conventional morphology and recent tissue-based molecular studies with a special emphasis on elucidating its tissue of origin from a pathologist's perspective. We also discuss unmet needs in pathology studies that would be important for advancing adenomyosis research.<\/jats:p>","DOI":"10.1055\/s-0040-1718922","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T23:10:46Z","timestamp":1603235446000},"page":"108-118","source":"Crossref","is-referenced-by-count":58,"title":["Pathology and Pathogenesis of Adenomyosis"],"prefix":"10.1055","volume":"38","author":[{"given":"Maria Facadio","family":"Antero","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Ayhan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Segars","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ie-Ming","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,10,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1146\/annurev-pathmechdis-012419-032654","article-title":"The origin and pathogenesis of endometriosis","volume":"15","author":"Y Wang","year":"2020","journal-title":"Annu Rev Pathol"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1111\/aogs.13364","article-title":"Endometriosis and adenomyosis are associated with increased risk of preterm delivery and a small-for-gestational-age child: a systematic review and meta-analysis","volume":"97","author":"M R Bruun","year":"2018","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"e0220256","DOI":"10.1371\/journal.pone.0220256","article-title":"Adverse obstetrical outcomes for women with endometriosis and adenomyosis: a large cohort of the Japan Environment and Children's Study","volume":"14","author":"T Harada","year":"2019","journal-title":"PLoS One"},{"issue":"S 02","key":"ref4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/09513590.2016.1232902","article-title":"Proangiogenic features in chronic pelvic pain caused by adenomyosis","volume":"32","author":"M Orazov","year":"2016","journal-title":"Gynecol Endocrinol"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/00004347-199607000-00005","article-title":"Pathologic findings from the Maryland Women's Health Study: practice patterns in the diagnosis of adenomyosis","volume":"15","author":"J D Seidman","year":"1996","journal-title":"Int J Gynecol Pathol"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.fertnstert.2011.05.090","article-title":"Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries","volume":"96","author":"K E Nnoaham","year":"2011","journal-title":"Fertil Steril"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jmig.2015.09.018","article-title":"Adenomyosis: a clinical review of a challenging gynecologic condition","volume":"23","author":"J Struble","year":"2016","journal-title":"J Minim Invasive Gynecol"},{"key":"ref8","first-page":"577","article-title":"Ueber Uterusdrusen-neubildung in Uterus and Ovariul Sarcomen","volume":"16","author":"C Rokitansky","year":"1860","journal-title":"Z Gesellschaft Aerzte Wien"},{"key":"ref9","first-page":"457","article-title":"Zur pathologischen anatomie des eileitercatarrhs","volume":"8","author":"H Chiari","year":"1887","journal-title":"Z Heilkunde"},{"key":"ref10","first-page":"32","article-title":"Uber eine adenomatose Wucherung der Serosa in einer Bauchnarbe","volume":"49","author":"R Meyer","year":"1903","journal-title":"Z Geburtshilfe Gynakol"},{"key":"ref11","volume-title":"Myomata of the Uterus","author":"H A Kelly","year":"1909"},{"key":"ref12","volume-title":"Adenomyoma of the Uterus","author":"T Cullen","year":"1908"},{"key":"ref13","volume-title":"Die Adenomyome und Cystadenome der Uterus-und Tubenwandung: ihre Abkunft von Resten des Wolff'schen K\u00f6rpers","author":"F Von Recklinghausen","year":"1896"},{"key":"ref14","first-page":"191","article-title":"Ein Fall von Cystofibroma uteri verum","volume":"9","author":"A Diesterweg","year":"1883","journal-title":"Z. 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