PATHOLOGICAL FINDINGS FROM THE MARYLAND WOMENS HEALTH STUDY - PRACTICE PATTERNS IN THE DIAGNOSIS OF ADENOMYOSIS

Criteria for the diagnosis of adenomyosis vary widely in practice. The reported frequency of adenomyosis in hysterectomy specimens varies fr om 5-70% in published series. In this study, 1252 pathology reports on hysterectomy specimens from women enrolled in the Maryland Women's He alth Study were reviewed. The frequency of adenomyosis was calculated based on two subgroups: 1114 reports from 15 hospitals, and 705 report s signed by 25 pathologists. The frequency of diagnosis of adenomyosis ranged from 12% to 58% among the 15 hospitals, and 10% to 88% among t he 25 pathologists. This wide variation could not be explained by diff erences in patient age or number of pregnancies, factors known to corr elate with the frequency of adenomyosis. These data suggest that adeno myosis may be overdiagnosed. Stringent and widely accepted criteria fo r the diagnosis of adenomyosis are needed, as epidemiologic studies of this common condition would be facilitated by the use of standard cri teria in practice.