Immunohistochemical evaluation of endometriotic lesions and disseminated endometriosis-like cells in incidental lymph nodes of patients with endometriosis.
OBJECTIVE
To investigate the frequency of endometriotic lesions and disseminated endometriotic-like cells in a series of incidentally removed lymph nodes (LNs) in patients with endometriosis.


METHODS
Retrospective study.


METHODS
University hospital endometriosis center.


METHODS
Premenopausal patients underwent surgery because of endometriosis-associated symptoms.


METHODS
Retrospective analysis of 108 coincidentally resected LNs of 24 patients with endometriosis. To identify endometriotic cells, immunohistochemical analysis of estrogen and progestogen receptor (ER-PR), CD10, and cytokeratin was performed.


METHODS
The occurrence of endometriotic lesions (ER-PR, CD10, and cytokeratin positive) and disseminated endometriotic-like ER-PR-positive cells in LNs.


RESULTS
Deep infiltrating endometriosis was diagnosed in 23 of the 24 patients with incidentally removed LNs. In 8 of 24 (33.3%) patients with incidentally removed LNs, typical endometriotic lesions were detected. Disseminated ER-PR-positive cells were found in 17 of 24 patients (70.8%). Lymph node involvement correlated directly with the deep infiltrating endometriosis lesional size.


CONCLUSIONS
Estrogen receptor-progestogen receptor-positive endometriotic lesions and disseminated endometriotic-like cells frequently are detected in LNs of patients with deep infiltrating endometriosis and, therefore, might reflect "nonlocalized" disease. If clinical significance of such lesions were provided, adjuvant hormonal treatment could be considered as a possible additional mode of therapy.
Endometriosis Research Center Charité, Department of Gynecology, Charité, Campus Benjamin Franklin, Berlin, Germany. sylvia.mechsner@charite.de
Sylvia
S
Mechsner
Miriam
M
Weichbrodt
Wolfram F J
WF
Riedlinger
Andreas M
AM
Kaufmann
Achim
A
Schneider
Christhard
C
Köhler
D000328:Adult; D004715:Endometriosis / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D033162:Incidental Findings; D007633:Keratins / Q000378:metabolism; D008198:Lymph Nodes / Q000378:metabolism* / Q000473:pathology*; D008875:Middle Aged; D015260:Neprilysin / Q000378:metabolism; D017697:Premenopause; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012002:Rectal Diseases / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D014623:Vaginal Diseases / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D007633:Keratins; D015260:Neprilysin