Location, color, size, depth, and volume may predict endometriosis in lesions resected at surgery.
OBJECTIVE
To correlate the diagnosis of endometriosis in lesions excised at laparoscopy with pathologic diagnosis.


METHODS
Prospective study.


METHODS
U.S. government research hospital.


METHODS
Women with chronic pelvic pain thought to be due to endometriosis.


METHODS
Excision of lesions suspicious for endometriosis.


METHODS
Histologic examination of lesions for color, width, depth, and location of endometriosis. Lesion colors were grouped as black, red, white, mixed color, or endometriomas.


RESULTS
Sixty-five women with a surgical diagnosis of endometriosis had minimal (n = 22), mild (n = 25), moderate (n = 9), or severe disease (n = 9) according to the revised American Fertility Society classification. Endometriosis was confirmed in all but seven patients with minimal and one with severe disease. Twelve other patients did not have endometriosis. Of 314 lesions excised, 189 (61%) were endometriotic. Black or red lesions were less often histologically confirmed to be endometriosis than were white lesions, mixed-color lesions or endometriomas. Lesions > 5 mm wide or deep were more likely to be endometriosis than were narrower or shallower implants. Endometriomas deeper than 1 cm were histologically confirmed to be endometriosis, and 50% of peritoneal windows contained endometriosis.


CONCLUSIONS
White lesions, mixed-color lesions, endometriomas, and larger lesions by depth or width were more likely to be histologically confirmed endometriosis than were smaller, black, or red lesions.
Stratton
Pamela
P
Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-1853, USA. ps79c@nih.gov
Winkel
Craig A
CA
Sinaii
Ninet
N
Merino
Maria J
MJ
Zimmer
Carolyn
C
Nieman
Lynnette K
LK
D000328:Adult; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery*; D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D010053:Ovary / Q000473:pathology; D010858:Pigmentation; D011446:Prospective Studies; D024162:Second-Look Surgery; D000267:Tissue Adhesions / Q000473:pathology