Home > E. Pathology by systems > Reproductive system > Female genital system > endometriosis
endometriosis
Monday 15 March 2004
| WKP | PO |
Definition : Presence of endometrial tissue outside of endometrium and myometrium, consisting of both endometrial glands and endometrial stroma.
Images
colorectal endomatriosis
vesical endometriosis
Nodule at site of previous Pfannenstiel incision , associated with cyclical pain.
CD10 in endometriosis
Localization
genital endometriosis
-
ovarian endometriosis
- ovarian endometriotic cyst
pulmonary endometriosis
subcutaneous endometriosis
vesical endometriosis
parietal endometriosis
- surgical incision site
Synopsis
At least 2 of the following 3 features :
Endometrial type glands:
- Müllerian type epithelium (can be atrophic to cycling endometrium)
- Can show degenerative atypia (enlarged smudgy nuclei) or metaplasia
Endometrial type stroma:
- Often contains fine capillary network
- May undergo smooth muscle metaplasia, fibrosis (longstanding), decidual change
- May be myxoid (particularly in pregnancy)
- Stroma may be only identifiable component (stromal endometriosis)
- Evidence of chronic hemorrhage (hemosiderin laden or foamy macrophages)
Other rare findings:
- Necrotic pseudoxanthomatous nodules: central necrosis surrounded by histiocytes and outer fibrous zone
- Liesegang rings: eosinophilic acellular rings within necrotic tissue (Histopathology 2020;76:76)
- Burnt out endometriosis: this term has been proposed for changes suggestive of endometriosis, such as central necrosis with surrounding fibrosis and pseudoxanthoma cells but lacking confirmatory features as listed above
Atypical endometriosis
this has been reported in 1.7 - 4.4% of endometriotic lesions
is considered the precursor lesion for endometriosis associated carcinomas (clear cell or endometrioid); may be in continuity with these tumors
Includes cytologic atypia in the epithelial lining of the glands or gland crowding lined by atypical epithelium resembling endometrial atypical hyperplasia (Histopathology 1997;30:249, Case Rep Oncol 2013;6:480)“”
IHC
CD10 expression by endometrial stroma in endometriosis
Digital case
JRC:6314 : pulmonary.
Predisposition loci
10q26
Associations
endometriosis-associated malignancies (EAM)
- Endometriosis is most associated with the development of endometrioid adenocarcinoma and clear cell adenocarcinoma.
References
Survivin, MMP-2, MT1-MMP, and TIMP-2: their impact on survival, implantation, and proliferation of endometriotic tissues. Londero AP, Calcagno A, Grassi T, Marzinotto S, Orsaria M, Beltrami CA, Marchesoni D, Mariuzzi L. Virchows Arch. 2012 Sep 6. PMID: 23011643
Matarese G, De Placido G, Nikas Y, Alviggi C. Pathogenesis of endometriosis: natural immunity dysfunction or autoimmune disease? Trends Mol Med. 2003 May;9(5):223-8. PMID: 12763528
