Difference between revisions of "Endometriosis"

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(→‎Diagnosis: +intestine)
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==Diagnosis==  
==Diagnosis==  
Need 2 of 3 criteria to diagnose.
Criteria - need at least 2 / 3 for the diagnosis:<ref name=Ref_DCHH239>{{Ref DCHH|239}}</ref>
 
Criteria:<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.
#Endometrial stroma - endometrial stroma is classically: cellular and hyperchromatic (may resemble a lymphocytic infiltration on low power).
#Endometrial stroma - endometrial stroma is classically: cellular and hyperchromatic (may resemble a lymphocytic infiltration on low power).
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Notes:  
Notes:  
*The epithelial component (1) may appear cuboidal in cysts ''or'' be sloughed-off, i.e. absent.
*The epithelial component (1) may appear cuboidal in cysts ''or'' be sloughed-off, i.e. absent.
*The microscopic correlation of ''cholocate 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... to the initiated eye.  
*Endometriosis may mimic cancer - see image below.
*If it is just endometrial type glands... it is probably [[endosalpingiosis]].  


===Images===
===Images===
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==Associations==
==Associations==
Endometriosis is associated with:
Endometriosis is associated with:
*[[Endometrioid adenocarcinoma]] of the [[ovary]]<ref>{{cite journal |author=Nagle CM, Olsen CM, Webb PM, Jordan SJ, Whiteman DC, Green AC |title=Endometrioid and clear cell ovarian cancers: a comparative analysis of risk factors |journal=Eur. J. Cancer |volume=44 |issue=16 |pages=2477-84 |year=2008 |month=November |pmid=18707869 |doi=10.1016/j.ejca.2008.07.009 |url=}}</ref>
*Endometrioid adenocarcinoma of the [[ovarian tumours|ovary]]<ref>{{cite journal |author=Nagle CM, Olsen CM, Webb PM, Jordan SJ, Whiteman DC, Green AC |title=Endometrioid and clear cell ovarian cancers: a comparative analysis of risk factors |journal=Eur. J. Cancer |volume=44 |issue=16 |pages=2477-84 |year=2008 |month=November |pmid=18707869 |doi=10.1016/j.ejca.2008.07.009 |url=}}</ref>
*Clear cell carcinoma of the ovary.<ref name=pmid18834345>{{cite journal |author=Kawaguchi R, Tsuji Y, Haruta S, ''et al.'' |title=Clinicopathologic features of ovarian cancer in patients with ovarian endometrioma |journal=J. Obstet. Gynaecol. Res. |volume=34 |issue=5 |pages=872–7 |year=2008 |month=October |pmid=18834345 |doi=10.1111/j.1447-0756.2008.00849.x |url=}}</ref>
*Clear cell carcinoma of the ovary.<ref name=pmid18834345>{{cite journal |author=Kawaguchi R, Tsuji Y, Haruta S, ''et al.'' |title=Clinicopathologic features of ovarian cancer in patients with ovarian endometrioma |journal=J. Obstet. Gynaecol. Res. |volume=34 |issue=5 |pages=872–7 |year=2008 |month=October |pmid=18834345 |doi=10.1111/j.1447-0756.2008.00849.x |url=}}</ref>
*Increased endocrine tumours, [[non-Hodgkin's lymphoma]], brain tumours and decreased [[cervical cancer]].<ref>[http://www.medicalnewstoday.com/articles/3890.php http://www.medicalnewstoday.com/articles/3890.php]</ref>  
*Increased endocrine tumours, [[non-Hodgkin's lymphoma]], brain tumours and decreased [[cervical cancer]].<ref>[http://www.medicalnewstoday.com/articles/3890.php http://www.medicalnewstoday.com/articles/3890.php]</ref>  
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==Immunohistochemical stains==
==Immunohistochemical stains==
*[[CD10]] [[stains]] the stromal cells<ref name=Ref_DCHH236>{{Ref DCHH|236}}</ref> - used to look for endometriosis.
*CD10 [[stains]] the stromal cells<ref name=Ref_DCHH236>{{Ref DCHH|236}}</ref> - used to look for endometriosis.


==See also==
==See also==

Revision as of 04:58, 15 April 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 - see image below.
  • If it is just endometrial type glands... it is probably endosalpingiosis.

Images

Associations

Endometriosis is associated with:

Immunohistochemical stains

  • CD10 stains the stromal cells[7] - 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. ↑ 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.
  4. ↑ 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.
  5. ↑ http://www.medicalnewstoday.com/articles/3890.php
  6. ↑ 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.
  7. ↑ 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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