Two Previously Unemphasized Features of Endometriosis: Micronodular Stromal Endometriosis and Endometriosis with Stromal Elastosis

This report draws attention to two unusual features of the stromal component of endometriosis that can create problems in diagnosis. One of these is the exclusive presence of endometriotic stroma, so-called stromal endometriosis, that can occasionally take the form of microscopic nodules of endometriotic stroma on the pelvic peritoneum and other locations. This finding, which we refer to as a micronodular stromal endometriosis, can be overlooked entirely or lead to confusion with peritoneal involvement by low-grade endometrial stromal sarcoma. The other finding we describe is the presence of a prominent elastotic stromal response to endometriosis that can occasionally obscure or even focally obliterate the typical endometriotic stroma. This finding, although nonspecific, can be a diagnostic clue to the presence of endometriosis, especially when accompanied by the presence of the typical endometriod glands of that lesion. Int J Surg Pathol 8(3):223-227, 2000     

Endometriosis of the Appendix

Endometriosis is a well known cause of infertility. Endometriosis of the appendix is a very rare condition. To highlight this rare entity, we are reporting a case of a young lady who was admitted with recurrent attacks of lower abdominal pain associated with primary infertility. Preoperative diagnosis was acute appendicitis. Histopathological examination of the appendix revealed endometriosis. Endometriosis should be considered in the differential diagnosis of recurrent lower abdominal pain in young females especially with history of infertility.     

Lymphocytes in Endometriosis

Citation Osuga Y, Koga K, Hirota Y, Hirata T, Yoshino O, Taketani Y. Lymphocytes in Endometriosis. Am J Reprod Immunol 2011; 65: 1–10 Endometriosis is a disease characterized by the presence of endometriotic tissue outside the uterine cavity. Although its pathogenesis remains to be elucidated, immune status is suggested to play an important role in the initiation and the progression of the disease. In particular, immune cells in lymphoid lineage that comprised T and B lymphocytes and natural killer cells play essential roles in determining either accept or reject survival, implantation, and proliferation of endometrial and endometriotic cells. Numerous studies have shown aberrant functions of these immune cells in women with endometriosis. The abnormalities include reduced activity of cytotoxic T cells and NK cells, cytokine secretion by helper T cells, and autoantibody production by B lymphocytes. These alterations are suggested to be induced by various manners and promote the disease. Understanding of these immune aspects in endometriosis is thus expected to benefit the treatment of the disease.     

子宫内膜异位症的超声诊断

目的探讨子宫内膜异位症的超声诊断价值。方法收集2012年1月~2013年12月在我院经过腹腔镜手术确诊患有子宫内膜异位症的93名患者超声影像特征,对比分析内在性子宫内膜异位症与外在性子宫内膜异位症的影响特征差异;结果 1子宫内膜异位症超声征象主要表现为:包块外形包块规则(占63%)、包块边界不清晰(占77.2%)、包块回声为无回声(占68.5%)或低回声(占27.2%)、内部无回声(占72.8%);无血流信号(占80.4%);2内在性子宫内膜异位症患者具有妊娠分娩史的占86.1%高于外在性子宫内膜异位症的66.1%;包块边界不清晰率88.9%高于外在性组的69.6%,组间差异显著;3超声诊断准确率达91.4%;结论超声对子宫内膜异位症的诊断便捷、准确率高、费用合理,但尚存在不符合特异征象的影像表现,需同时结合临床病史及其他指标进行联合诊断。