Decidualization of Endometriosis in Macaques.
The decidua is the superficial portion of endometrium that transforms, or decidualizes, under the influence of progesterone to nourish the early embryo during pregnancy. Deciduae outside the uterus are found in nearly 100% of human pregnancies. This condition, known as deciduosis, may mimic malignancy, resulting in additional diagnostic procedures that place the mother, baby, or both at risk. Deciduosis has been described in both Old World and New World nonhuman primates in conjunction with pregnancy and after treatment with exogenous progestins. Here the authors present 6 cases of deciduosis associated with endometriotic lesions in female rhesus and cynomolgus macaques (Macaca mulatta and Macaca fascicularis). Full diagnostic necropsies with histologic analyses were performed on all animals. Deciduae were stained with hematoxylin and eosin and by immunohistochemistry for vimentin, CD10, progesterone receptor, estrogen receptor, desmin, cytokeratin, kermix P8, chorionic gonadotropin, human placental lactogen, and calretinin. The most common clinical signs were abdominal pain (4 of 6) and anorexia (2 of 6). At necropsy, macaque uteri were often enlarged or disfigured (4 of 6) with abundant fibrous adhesions (5 of 6). Affected tissue consisted of epithelial-lined cysts and decidualized stroma with scattered gamma/delta T cells. Decidualized stromal cells were large and polyhedral with abundant cytoplasm and round vesicular nuclei. They stained positive for vimentin, CD10, progesterone, and estrogen. In summary, these cases illustrate deciduosis in 6 nonhuman primates with endometriosis. Understanding decidualization in nonhuman primates will aid in elucidating the pathophysiology of deciduosis during pregnancy or endometriosis and potentially lead to new interventions.
Department of Pathology, Section on Comparative Medicine, School of Medicine, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC, USA.
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Atkins
Division of Comparative Pathology, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Lombardini
Department of Pathology, Section on Comparative Medicine, School of Medicine, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC, USA.
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Caudell
Department of Pathology, Section on Comparative Medicine, School of Medicine, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC, USA.
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Appt
Department of Medicine, F. Edward Hébert School of Medicine, Laboratory of Gastrointestinal and Liver Studies, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Dubois
Department of Pathology, Section on Comparative Medicine, School of Medicine, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC, USA jmcline@wakehealth.edu.
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Cline
D000818:Animals; D003656:Decidua / Q000473:pathology*; D004715:Endometriosis / Q000473:pathology / Q000662:veterinary*; D004717:Endometrium / Q000473:pathology; D005260:Female; D008252:Macaca fascicularis; D008253:Macaca mulatta; D008992:Monkey Diseases / Q000473:pathology*
disease process; immunohistochemistry; infectious; laboratory animals; other; primate; reproductive; species; technology; tissue