The lesion is entirely composed of proliferating glands of endocervical type surrounded by fascicles of smooth muscle. There is an appearance of papillary infoldings to the proliferating glands.
The smooth muscle appears as tapered cells condensing around the glandular epithelium.
The epithelium contains pale bluish mucin consistent with endocervical morphology. Endocervical-type acellular mucin is present within the lumina of these glands.
CD10 stains the spindle cells cuffing the glands.
Adenomyomas of the cervix are benign biphasic tumors composed of endocervical glands and smooth muscle. These lesions may also arise in the endometrium. Grossly, they are well-circumscribed and may prolapse through the external os. Microscopically, endocervical-type glands are often large, irregularly shaped with papillary infoldings. The glands are surrounded by smooth muscle. Unlike adenoma malignum, the main entity on the differential, the nuclear and cytologic features are bland, and there is no desmoplasia or mitotic activity.
In a review of 10 cases of cervical adenomyoma of endocervical type, patients ranged from 21 to 55 years of age with an average age of 40 (Gilks). Two patients presented with abnormal vaginal bleeding, but in most cases, the lesions did not cause symptoms. Lesions ranged from 1.3 to 8.0 cm, and some prolapsed through the os.
These lesions are benign. Treatment depends on the size and location of the adenomyoma and generally involves excision, ranging from a polypectomy to a simple hysterectomy.
Gilks CB, Young RH, Clement PB, Hart WR, Scully RE. Adenomyomas of the uterine cervix of of endocervical type: a report of ten cases of a benign cervical tumor that may be confused with adenoma malignum. Mod Pathol. 1996 Mar;9(3):220-4.