45 year old woman with heavy periods associated with lower abdominal discomfort during menstruation.
The uterus is enlarged and appears globular. The myometrium is relatively diffusely thickened and appears trabeculated. There are areas of haemorrhage within the myometrium (seen on the left side). Sometimes, the haemorrhage may appear more punctate (small spots of haemorrhage). Two small leiomyomas are seen in the fundus.