A comparative study of ovarian and pelvic wall-infiltrating endometriosis.
OBJECTIVE
To compare the histology of ovarian endometriomas (OE) with that of pelvic wall-infiltrating endometriosis (PWIE) in an attempt to elucidate their histopathologic and clinical differences.


METHODS
Retrospective histologic study.


METHODS
University-affiliated hospital.


METHODS
Randomly selected tissue samples of 10 cases each of OE and PWIE. Interventions. Immunoperoxidase and Masson's trichrome stains were applied to the samples to determine the presence of myofibroblasts and collagen, respectively.


RESULTS
All cases of OE showed changes suggestive of type 3 collagen deposition and myofibroblast proliferation. All cases of PWIE showed changes suggestive of type 1 collagen deposition and extensive smooth muscle metaplasia. The endometrial glands and stroma of OE tended to be on the inside lining of the chocolate cyst and did not freely intermix with native ovarian collagen. The lesions of PWIE, however, showed endometrial glands and stroma mixing freely with the native pelvic wall collagen.


CONCLUSIONS
These findings suggest two different mechanisms for the pathogenesis of OE and PWIE and offer a rationale for using different surgical approaches to the different sites. Ovarian endometriosis is a lesion within the ovary with a response compatible with recent metastasis, whereas PWIE appears to be a metaplastic reaction.
Khare
V K
VK
Department of Pathology, University of Tennessee, Memphis, Tennessee, USA.
Martin
D C
DC
Eltorky
M
M
D004396:Coloring Agents; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008679:Metaplasia; D009130:Muscle, Smooth / Q000473:pathology; D010049:Ovarian Diseases / Q000473:pathology*; D012189:Retrospective Studies
D004396:Coloring Agents