[Clinico-morphological features of endometrioid disease: adenomyosis, ovarian endometriosis, extragenital endometriosis].

Adenomyosis, ovarian endometriosis and extragenital endometriosis are clinico-pathologic types of one nosologic form as endometrioid disease (ED). ED's clinical presentations are various, but they are essentially characterized by a pain syndrome and disorder of menstrual cycle. The comparative clinico-pathologic analysis of adenomyosis, ovarian endometriosis, and extragenital endometriosis affords to suppose that theirs clinical course, the intensity and character of symptoms, as well as morphogenetic processes are generally determined by the organ localization. Topography of foci, theirs organ localization, morphological and morphofunctional features vary within one type of ED and even within one organ. So the separation of various ED's morphofunctional forms, its clinico-phatological features and intensity of its morphofunctional activity is necessary. All forms of ED have general morphogenesis features including the various form of proliferation, secretion, regression, wave-like courses of dishormonal morphogenetic manifestation within one organ. Typical for all ED's types pathologic synthesis of aromatase cytochrome P-450 promotes the local estrogens synthesis from androgens, transition of endometrioid heterotopias to the quite different level of existence and self-regulation contributing autonomous wave-like chronic ED' clinic course.

[Cancer transformation of adenomyosis].

Adenomyosis cancerous transformation (AMCT) was observed in a 48-year old female without cancer of the endometrium. Various forms of transformation (stages of AMCT morphogensis) in and outside of denomyosis (AM) foci are described (adenomatosis, invasive cancer, metastases). AMCT diagnosis requires histologic examination of the surgical material with establishing multicentric tumor transformation of AM foci at different stages of morphogenesis. Early intramural tumor cell embolism and metastases worsens prognosis.

[Combination of uterine adenomyosis with leiomyoma].

A morphological analysis of 50 cases of adenomyosis (AM) and 150 cases of AM combination with leiomyoma (LM) with regard to their morphofunctional and histotopographical interrelations was performed. The asynchronous character and mosaicism of estrogen/progesteron receptors expression in the gland epithelium and AM stromal cells of one patient was established immunohistochemically. This probably determines uneffective hormonal therapy of AM patients. A correlation of steroid hormone receptor expression in AM foci and in leiomyocytes of perifocal myometrium hyperplasia was also found. This indicates a common pathogenic mechanism of AM and LM. An increase of the size of the uterus depended on the degree of perifocal leiomyocyte hyperplasia with microscopical nodule formation in LM.