Standardizing the histopathological diagnosis of adenomyosis

Standardizing the histopathological diagnosis of adenomyosis: an international Delphi consensus

• McCaughey, T., Newman, M., Constable, L., Figueiredo, F., Mooney, S. S., Reddington, C., McNamara, H. C., Kennedy, A. L., & Healey, M. (2025). Standardizing the histopathological diagnosis of adenomyosis: an international Delphi consensus. Histopathology, 87(3), 446–452. https://doi.org/10.1111/his.15480

This study aimed to create standardized guidelines for diagnosing adenomyosis, a condition affecting the uterus, by using a method called the Delphi consensus. From April to September 2024, 31 expert gynaecological pathologists from 18 countries participated in surveys to help develop and refine these guidelines, particularly focusing on how to analyze tissue samples from hysterectomies.

They gained strong agreement on several key points:

1. Adenomyosis should be defined based on how far the endometrial glands or tissue grow into the muscle of the uterus.
2. The total number of glands or tissue is not necessary for diagnosis; even one gland can be enough.
3. Clear definitions were established for various types of adenomyosis.

An impressive 93% of participants supported the idea of standardizing these diagnostic criteria to minimize differences in assessments by different pathologists. The result is the first set of consensus guidelines for diagnosing adenomyosis, which will help pathologists make more consistent diagnoses. Future research is encouraged to connect these criteria with patients' symptoms and treatment outcomes.

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