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A 42-year-old G2P2 undergoes a hysterectomy for definitive treatment of her dysmenorrhea and large uterine fibroids. The uterus is sent to pathology. Which of the following would confirm the diagnosis of fibroids?

A. Blue-domed cysts greater than 3 mm
B. Decidual effect in the endometrium
C. Endometrial glands/stroma and hemosiderin-laden macrophages
D. Invasion of endometrial glands into the myometrium
E. Well-circumscribed, non-encapsulated myometrium

1 Answer

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Final answer:

The confirmation of fibroids following a hysterectomy for a 42-year-old G2P2 would be through the identification of (D) well-circumscribed, non-encapsulated myometrial nodules on pathology, which are characteristic of uterine fibroids.

Step-by-step explanation:

The diagnosis of fibroids in a 42-year-old G2P2 who has undergone a hysterectomy would be confirmed by finding well-circumscribed, non-encapsulated myometrial nodules. Uterine fibroids, also known as leiomyomas, are benign smooth muscle tumors of the uterus and they typically appear as well-defined, firm nodules within the myometrium. These are non-encapsulated, but they are well circumscribed, which means they can be distinctly separated from surrounding tissue.

Options such as blue-domed cysts greater than 3 mm are characteristic of endometriosis, appearing as endometrial tissue implants outside the uterus. The decidual effect in the endometrium is associated with pregnancy. Endometrial glands/stroma and hemosiderin-laden macrophages can also indicate endometriosis. Invasion of endometrial glands into the myometrium, also known as adenomyosis, is a different condition where the inner lining of the uterus breaks through the muscle wall of the uterus.

In summary, to confirm fibroids, pathologists look for myometrial nodules that are well-circumscribed and which match the descriptions typically associated with uterine fibroids.

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