title: Ultramicro-trauma in the endometrial-myometrial junctional zone and pale cell migration in adenomyosis.
abstract: OBJECTIVE
  To determine if ultrastructural tissue trauma occurs in the junctional zone in uteri in adenomyosis.
  
  
  METHODS
  A case-control experimental study.
  
  
  METHODS
  Endometriosis research center.
  
  
  METHODS
  Twelve uteri with adenomyosis, and 9 uteri without adenomyosis, were gained during laparoscopy-assisted vaginal hysterectomy.
  
  
  METHODS
  Transmission electron microscopic study of the junctional zone, as well as immunohistochemical staining for epithelial cadherin, and van Gieson staining and immunofluorescence for CD45 and CD68.
  
  
  METHODS
  Analysis of the electron microscopy photos and the immunoreactive scores of the staining.
  
  
  RESULTS
  The inner myometrial muscle fibers were diversely arranged in adenomyosis; they were parallel to the basal endometrial glands in nonadenomyosis. Nuclear membrane infolding of the basal glandular epithelium and the disruption of the interface between basal endometrium and inner myometrium in adenomyosis (but not in nonadenomyosis) were evident. Intraepithelial pale cells were seen in the basal endometrial glands in both groups, but they lacked CD45 and CD68 expression. They were seen actively migrating into the stroma in adenomyosis only.
  
  
  CONCLUSIONS
  The myofiber disarray in the inner myometrium, and the nuclear membrane irregularities in adenomyosis, are evidence for ultramicro-trauma in adenomyosis. The migrating nonleukocytic pale cells may be involved in pathogenesis of adenomyosis.
authors.affiliation: Clinic for Gynaecology, Charité University of Medicine, Berlin, Germany.
authors.forename: Mohamed G
authors.initials: MG
authors.lastname: Ibrahim
authors.affiliation: Clinic for Gynaecology, Charité University of Medicine, Berlin, Germany.
authors.forename: Vito
authors.initials: V
authors.lastname: Chiantera
authors.affiliation: Clinic for Gynaecology, Charité University of Medicine, Berlin, Germany.
authors.forename: Sergio
authors.initials: S
authors.lastname: Frangini
authors.affiliation: Clinic for Gynaecology, Charité University of Medicine, Berlin, Germany.
authors.forename: Shadi
authors.initials: S
authors.lastname: Younes
authors.affiliation: Clinic for Gynaecology, Asklepios Clinic of Hamburg, Hamburg, Germany.
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
authors.affiliation: Department of Pathology, Charité University of Medicine, Berlin, Germany.
authors.forename: Eliane T
authors.initials: ET
authors.lastname: Taube
authors.affiliation: Department of Veterinary Anatomy, Institute of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Plendl
authors.affiliation: Clinic for Gynaecology, Charité University of Medicine, Berlin, Germany. Electronic address: sylvia.mechsner@charite.de.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Mechsner
mesh_terms: D062788:Adenomyosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D015415:Biomarkers; D015820:Cadherins / Q000032:analysis; D016022:Case-Control Studies; D002465:Cell Movement; D004717:Endometrium / Q000737:chemistry / Q000601:surgery / Q000648:ultrastructure*; D004847:Epithelial Cells / Q000737:chemistry / Q000648:ultrastructure*; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods; D007150:Immunohistochemistry; D010535:Laparoscopy; D017493:Leukocyte Common Antigens / Q000032:analysis; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009210:Myofibrils / Q000737:chemistry / Q000648:ultrastructure; D009215:Myometrium / Q000737:chemistry / Q000601:surgery / Q000648:ultrastructure*; D010641:Phenotype; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D015820:Cadherins; D017493:Leukocyte Common Antigens; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C513384:CDH1 protein, human; C516769:PTPRC protein, human
keywords: Adenomyosis pathogenesis; endometrial-myometrial junctional zone; pale cells; ultrastructure