How do the uterine characteristics differ between leiomyomas and adenomyosis?

In distinguishing between leiomyomas and adenomyosis, it's important to understand their morphological characteristics. Leiomyomas, also known as uterine fibroids, are typically asymmetrical due to their varied sizes and locations within the uterus. They are hard or firm to the touch because of their smooth muscle composition. On imaging, these fibroids often appear as distinct masses that can distort the shape of the uterus, contributing to their asymmetrical presentation.

In contrast, adenomyosis is characterized by the presence of endometrial tissue within the muscular layer of the uterus. This condition usually leads to a more generalized enlargement of the uterus, resulting in a symmetrical appearance. The texture of the uterus in adenomyosis can feel softer than that of leiomyomas, and it is often associated with tenderness due to inflammation and the involvement of surrounding tissues.

Thus, the differentiation based on symmetry and firmness is crucial: leiomyomas are asymmetrical and firm, while adenomyosis tends to present as a more uniform, symmetrical, and softer enlargement.