Myometrial vessels are filled with benign endometrium.
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Intravascular endometrium is the presence of endometrial tissue within myometrial vessels. This phenomenon is more common that expected. In a study of 277 hysterectomy specimens, intravascular endometrium was identified in 14 cases -- all 14 cases had concurrent adenomyosis (Sahin).
Finding small dark stromal cells with associated glands inside parametrial blood vessels can be alarming -- as one begins to think of carcinoma, sarcoma or lymphoma with intravascular invasion. However, intravascular endometrium is a benign entity that ought to be considered, especially if the clinical picture is fitting (Banks).
• Myometrium : Intravascular Leiomyomatosis
Sahin AA, Silva EG, Landon G. Endometrial tissue in myometrial vessels not associated with menstruation. Int J Gynecol Pathol 1989;8(2):139-46.
Banks ER, Mills SE, Frierson HF Jr. Uterine intravascular menstrual endometrium simulating malignancy. Am J Surg Pathol. 1991 Apr;15(4):407-12.