The patients' ages ranged from 30 to 55 years. Most lesions were grossly polypoid; a minority were intramural or exophytic. In six of seven endocervical
adenomyomas received in consultation,
adenoma malignum was considered. A variety of benign lesions, including lobular endocervical glandular
hyperplasia (LEGH),
adenofibroma, endocervicosis and tunnel clusters, were also considered. The endocervical
adenomyomas consisted of bland mucinous glands, sometimes with focal epithelial
metaplasia, within a prominent smooth muscle stroma. There was usually a focal lobular architecture and sometimes papillary infoldings. A characteristic feature was a rim of stroma surrounding glands, surrounded in turn by smooth muscle. Previously undescribed features were 'symplastic-like' smooth muscle, stromal adipose tissue, gland
rupture with
mucin extravasation, prominent
adenofibroma-like areas and surface
cervical intraepithelial neoplasia (CIN). Diffuse oestrogen receptor (ER) immunoreactivity was useful in excluding
adenoma malignum and LEGH, which are
hormone receptor-negative. The mesonephric
adenomyoma consisted of a lobular arrangement of mesonephric glands [ER/
progesterone receptor (PR)-negative;
vimentin and
luminal CD10 immunoreactivity] within a smooth muscle stroma.
CONCLUSIONS: Endocervical and mesonephric
adenomyomas are rare lesions which are often misdiagnosed, possibly because of lack of familiarity among pathologists.