Difference between revisions of "Endometriosis"
Jump to navigation
Jump to search
(→Diagnosis: wikify, +DDx) |
|||
| Line 7: | Line 7: | ||
*Associated with moderate elevation of (serum) CA-125. | *Associated with moderate elevation of (serum) CA-125. | ||
== | ==Gross== | ||
*''Chocolate cyst'' = cyst containing light brown material. | |||
==Microscopic== | |||
Criteria - need at least 2 / 3 for the diagnosis:<ref name=Ref_DCHH239>{{Ref DCHH|239}}</ref> | Criteria - need at least 2 / 3 for the diagnosis:<ref name=Ref_DCHH239>{{Ref DCHH|239}}</ref> | ||
#Endometrial glands - endometrial glands are classically: circular, with nuclei that are hyperchromatic & cigar-shaped. | #Endometrial glands - endometrial glands are classically: circular, with nuclei that are hyperchromatic & cigar-shaped. | ||
Revision as of 03:52, 13 January 2012
Endometriosis causes significant morbidity and is associated with increased risk of certain malignancies.
Clinical
- A cause of infertility.
- A cause of pelvic pain.
- Affects approximately 10% of women of child bearing age.
- Associated with moderate elevation of (serum) CA-125.
Gross
- Chocolate cyst = cyst containing light brown material.
Microscopic
Criteria - need at least 2 / 3 for the diagnosis:[1]
- Endometrial glands - endometrial glands are classically: circular, with nuclei that are hyperchromatic & cigar-shaped.
- Endometrial stroma - endometrial stroma is classically: cellular and hyperchromatic (may resemble a lymphocytic infiltration on low power).
- Hemosiderin-laden macrophages - light brown, may be granular.
Notes:
- The epithelial component (1) may appear cuboidal in cysts or be sloughed-off, i.e. absent.
- The microscopic correlation of chocolate cyst is: light brown acellular material; this can be considered as a substitute for (3) - hemosiderin-laden macrophages.
- Epithelial component may have tubal metaplasia.[2]
- Endometriosis may mimic cancer[3] - see images below.
- If it is just endometrial type glands - the stroma is missing... it is probably endosalpingiosis.
DDx:
Images
Mimicking cancer:
- Endometriosis in the small intestine - low mag. (WC).
- Endometriosis in a lymph node - intermed. mag. (WC).
Associations
Endometriosis is associated with gynecologic tumours:
- Endometrioid adenocarcinoma of the ovary[4]
- Clear cell carcinoma of the ovary.[5]
- Endocervical-like mucinous borderline tumour (EMBT).[6]
- Mixture of EMBT and serous borderline tumor = seromucinous borderline tumour.
Other tumours & decreased risk:[7]
- Increased: endocrine tumours, non-Hodgkin's lymphoma, brain tumours.
- Decreased: cervical cancer.
Immunohistochemical stains
See also
References
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 239. ISBN 978-0470519035.
- ↑ Clement PB (July 2007). "The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects". Adv Anat Pathol 14 (4): 241–60. doi:10.1097/PAP.0b013e3180ca7d7b. PMID 17592255.
- ↑ Corben, AD.; Nehhozina, T.; Garg, K.; Vallejo, CE.; Brogi, E. (Aug 2010). "Endosalpingiosis in axillary lymph nodes: a possible pitfall in the staging of patients with breast carcinoma.". Am J Surg Pathol 34 (8): 1211-6. doi:10.1097/PAS.0b013e3181e5e03e. PMID 20631604.
- ↑ Nagle CM, Olsen CM, Webb PM, Jordan SJ, Whiteman DC, Green AC (November 2008). "Endometrioid and clear cell ovarian cancers: a comparative analysis of risk factors". Eur. J. Cancer 44 (16): 2477-84. doi:10.1016/j.ejca.2008.07.009. PMID 18707869.
- ↑ Kawaguchi R, Tsuji Y, Haruta S, et al. (October 2008). "Clinicopathologic features of ovarian cancer in patients with ovarian endometrioma". J. Obstet. Gynaecol. Res. 34 (5): 872–7. doi:10.1111/j.1447-0756.2008.00849.x. PMID 18834345.
- ↑ Moriya T, Mikami Y, Sakamoto K, et al. (December 2003). "Endocervical-like mucinous borderline tumors of the ovary: clinicopathological features and electron microscopic findings". Med Electron Microsc 36 (4): 240–6. doi:10.1007/s00795-003-0221-4. PMID 16228656.
- ↑ URL: http://www.medicalnewstoday.com/articles/3890.php. Accessed on: 26 September 2011.
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 236. ISBN 978-0470519035.