Difference between revisions of "Endometriosis"

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*The microscopic correlation of ''chocolate cyst'' is: light brown acellular material; this can be considered as a substitute for (3) - ''hemosiderin-laden macrophages''.
*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.<ref name=pmid17592255>{{cite journal |author=Clement PB |title=The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects |journal=Adv Anat Pathol |volume=14 |issue=4 |pages=241–60 |year=2007 |month=July |pmid=17592255 |doi=10.1097/PAP.0b013e3180ca7d7b |url=}}</ref>
*Epithelial component may have tubal metaplasia.<ref name=pmid17592255>{{cite journal |author=Clement PB |title=The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects |journal=Adv Anat Pathol |volume=14 |issue=4 |pages=241–60 |year=2007 |month=July |pmid=17592255 |doi=10.1097/PAP.0b013e3180ca7d7b |url=}}</ref>
*Endometriosis may mimic [[cancer]] - see image below.
*Endometriosis may mimic [[cancer]]<ref name=pmid20631604>{{Cite journal  | last1 = Corben | first1 = AD. | last2 = Nehhozina | first2 = T. | last3 = Garg | first3 = K. | last4 = Vallejo | first4 = CE. | last5 = Brogi | first5 = E. | title = Endosalpingiosis in axillary lymph nodes: a possible pitfall in the staging of patients with breast carcinoma. | journal = Am J Surg Pathol | volume = 34 | issue = 8 | pages = 1211-6 | month = Aug | year = 2010 | doi = 10.1097/PAS.0b013e3181e5e03e | PMID = 20631604 }}</ref> - see images below.
*If it is just endometrial type glands... it is probably [[endosalpingiosis]].  
*If it is just endometrial type glands... it is probably [[endosalpingiosis]].  


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*[http://commons.wikimedia.org/wiki/File:Endometrioma1.jpg Endometriosis - low mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Endometrioma1.jpg Endometriosis - low mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Endometrioma3.jpg Endometriosis - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Endometrioma3.jpg Endometriosis - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Intestine_with_endometriosis_-_low_mag.jpg Endometriosis in small intestine - low mag. (WC)].
 
Mimicking cancer:
*[http://commons.wikimedia.org/wiki/File:Intestine_with_endometriosis_-_low_mag.jpg Endometriosis in the small intestine - low mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Endometriosis_lymph_node_-_2_-_intermed_mag.jpg Endometriosis in a lymph node - intermed. mag. (WC)].


==Associations==
==Associations==

Revision as of 03:28, 14 September 2011

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.

Diagnosis

Criteria - need at least 2 / 3 for the diagnosis:[1]

  1. Endometrial glands - endometrial glands are classically: circular, with nuclei that are hyperchromatic & cigar-shaped.
  2. Endometrial stroma - endometrial stroma is classically: cellular and hyperchromatic (may resemble a lymphocytic infiltration on low power).
  3. 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... it is probably endosalpingiosis.

Images

Mimicking cancer:

Associations

Endometriosis is associated with:

Immunohistochemical stains

  • CD10 stains the stromal cells[8] - used to look for endometriosis.

See also

References

  1. ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 239. ISBN 978-0470519035.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ http://www.medicalnewstoday.com/articles/3890.php
  7. ↑ 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.
  8. ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 236. ISBN 978-0470519035.
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