Lymph node involvement and lymphovascular invasion in deep infiltrating rectosigmoid endometriosis.
OBJECTIVE
To analyze the lymph node involvement by endometriotic foci in rectosigmoid endometriosis and to correlate it with clinical and histological parameters including the presence of lymphovascular invasions, which could explain this lymph node involvement.


METHODS
A prospective study of 26 consecutive cases of rectosigmoid endometriosis between January 2005 and January 2007.


METHODS
A multidisciplinary study including clinical and pathological data.


METHODS
Twenty-six patients with symptomatic rectosigmoid endometriosis.


METHODS
Laparoscopic surgery with pathological analysis of each specimen.


METHODS
Involvement of lymph nodes by endometriotic foci was correlated with the size and the wall layers affected by endometriotic lesions, the number of lymph nodes retrieved, and the presence of lymphovascular invasions demonstrated by D2-40, a specific antibody to lymphatic vessels.


RESULTS
Lymph node involvement by endometriosis was observed in 11 of the 26 patients (42.3%) and correlated with the size of the lesions, the number of lymph nodes retrieved, and the presence of lymphovascular invasions, which were observed in 36.3% of cases.


CONCLUSIONS
Our data confirm that lymph node involvement by endometriotic foci is a frequent event in rectosigmoid endometriosis and may result at least partially from a lymphatic spread of the disease.
Department of Pathology, Erasme University Hospital, Free University of Brussels, Brussels, Belgium. Electronic address: jenoel@ulb.ac.be.
Jean-Christophe
JC
Noël
Department of Gynecology, CHU Cochin-Saint Vincent de Paul, Université Paris V, Paris, France.
Charles
C
Chapron
Department of Pathology, Erasme University Hospital, Free University of Brussels, Brussels, Belgium.
Isabelle
I
Fayt
Department of Gynecology, Erasme University Hospital, Free University of Brussels, Brussels, Belgium.
Vincent
V
Anaf
D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000378:metabolism; D058846:Antibodies, Monoclonal, Murine-Derived; D015415:Biomarkers / Q000378:metabolism; D003106:Colon / Q000473:pathology*; D004715:Endometriosis / Q000473:pathology* / Q000503:physiopathology; D004729:Endothelium, Lymphatic / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D042583:Lymphangiogenesis / Q000502:physiology*; D042601:Lymphatic Vessels / Q000276:immunology / Q000473:pathology*; D011446:Prospective Studies; D012007:Rectum / Q000473:pathology*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D015415:Biomarkers; C500987:monoclonal antibody D2-40