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Ultrasound Showed Cystic Structure In Endometrial Cavity And Heterogeneous Myometrium. What Does This Mean?

Posted on Sat, 7 Dec 2013

Question: Hi, I am 37, have had 2 kids, am overweight, and before this, my cycles were very regular. I was sent for a transvaginal ultrasound because I was spotting before and after periods, occasional spotting after intercourse and having heavier and more painful periods. This is what was found (LMP about 2 weeks before): Uterus is retroverted. Endometrium is 10mm thick. A tiny cystic structure found in right upper endometrial cavity adjacent to myometrium, measuring 4mm in diameter. Myometrium is somewhat heterogeneous in appearance. Both ovaries appear normal. No pelvic masses or free fluid seen. I was wondering what this cystic structure could be (pregnancy has been ruled out) and if the heterogeneous myometrium should be of concern since I have read that it is abnormal and should be homogeneous. Could these findings be cause for my symptoms? Thank you.

Answered by Dr. Rhea Chanda (23 minutes later)

Brief Answer: Detailed below Detailed Answer: Hi XXXXXXX The ultrasound shows only a small cyst area in the myometrium. It cannot be termed an abnormality yet. As I see your LMP was 2 weeks before the ultrasound was done, so that means it was mid cycle when the ultrasound was done. In mid cycle, the myometrium is always thick and may show some cyctic areas. I would suggest that you repeat the ultrasound just after your period ends. If the report is the same then a biopsy needs to be done. Small nabothian cysts etc are common and not harmful. But the biopsy can only confirm.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Rhea Chanda (42 minutes later)

Hello, Thank you for your response. I was referring to the heterogeneous nature of my myometrium as being abnormal and not the cyst in my endometrial cavity. From what I know, the myometrium is supposed to be homogeneous. Please comment on this as i am more concerned about this finding. Should I be concerned that this may be a symptom of adenomyosis or fibroids? Should the cyst go away on its own? Also, what were you referring to as may needing to be biopsied? Thank you.

Answered by Dr. Rhea Chanda (30 minutes later)

Brief Answer: .d/c Detailed Answer: The heterogenous mupometrium is termed such, due to the cystic area. It means the myometrium is not evenly smooth as it should be. As I said, that can occur mid cycle. Hence the need to repeat the ultrasound, post menstrual. If it is still heterogenous then an endometrial biopsy which is a minor procedure may be done. Adenomyosis may become a possibility later. But till now your uterine size is normal. Hope it is clear now. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rhea Chanda (7 hours later)

Thank you. Yes, that does clear some of it up. I was confused because I thought the endometrial cavity was different than the myometrium, although they are beside each other. What would the biopsy be ruling out? Again, thank you for your help.

Answered by Dr. Rhea Chanda (24 minutes later)

Brief Answer: both part of the uterus Detailed Answer: The endometrium and myometrium are both part of the uterus . The biopsy is taken from the endometrial cavity by a procedure called curettage . The sample is then sent for biopsy . It will rule out infection and malignancy .

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Above answer was peer-reviewed by : Dr. Vaishalee Punj