Endometriosis
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]
- 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 - see image below.
- If it is just endometrial type glands... it is probably endosalpingiosis.
Images
- Endometriosis - ovary (WC).
- Endometriosis - low mag. (WC).
- Endometriosis - high mag. (WC).
- Endometriosis in small intestine - low mag. (WC).
Associations
Endometriosis is associated with:
- Endometrioid adenocarcinoma of the ovary[3]
- Clear cell carcinoma of the ovary.[4]
- Increased endocrine tumours, non-Hodgkin's lymphoma, brain tumours and decreased cervical cancer.[5]
- Endocervical-like mucinous borderline tumor.[6]
Immunohistochemical stains
See also
- Gynecologic pathology - overview.
- Immunohistochemical staining.
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.
- ↑ 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.
- ↑ http://www.medicalnewstoday.com/articles/3890.php
- ↑ 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.
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 236. ISBN 978-0470519035.