Figure 4. Adenoma malignum seen in a 49-year-old woman with a large amount of watery discharge (histopathologically proven from a hysterectomy specimen; shown as a reference case). (a) Fat-suppressed T₂ weighted spin echo axial image depicts multilocular cystic lesions extending into deep cervical stroma with perifocal oedema. (b) Fat-suppressed gadolinium-enhanced T₁ weighted sagittal image depicts multilocular cystic mass. The cyst walls are slightly thickened, and nodularly enhanced areas are shown among the cysts. (c) A photomicrograph shows multiple cystic lesions composed of a single layer of columnar cells that resemble normal endocervical glands. However, most glands have cellular atypia and structural dysplasia with multiple lobulations demonstrating a "hair-pin" shape. In another specimen (not shown), mucinous fluid leakage into the cervical stroma is also seen. Taking all of the above findings into consideration, adenoma malignum is thus considered to be the most likely histopathological diagnosis (original magnification x10; haematoxylin & eosin stain).