A comparative study of ovarian and pelvic wall-infiltrating endometriosis
Abstract
Study 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.Design Retrospective histologic study.Setting University-affiliated hospital.Subjects 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.Measurements and main 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.
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Extended exposure to TGF-β1 results in elevated expression of α-SMA and markers of terminally differentiated smooth muscle cells in the stromal component of endometriotic lesions, accounting for SMM.
“Extended exposure to TGF-β1 also results in elevated expression of α-smooth muscle actin (α-SMA) and of markers of terminally differentiated smooth muscle cells (SMCs) in the stromal component of endometriotic lesions, accounting for SMM that is common in endometriotic lesions23–26.”
From Neuropeptides Substance P and Calcitonin Gene Related Peptide Accelerate the Development and Fibrogenesis of Endometriosis (2019) · cites this paper as [24]
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- Authors
- Khare, V. K., Martin, D. C., & Eltorky, M.
- Affiliations
- Baptist Memorial Hospital (US)
- University of Tennessee Health Science Center (US)
- Corresponding author
- Khare, Vivek K.
- ORCID
- Martin, Dan C.
- Venue
- The Journal of the American Association of Gynecologic Laparoscopists
- Publisher
- Elsevier BV
- Published
- 1996-02
- Volume
- 3
- Issue
- 2
- Pages
- 235-239
- ISSN
- 1074-3804 (ISSN-L)
- OpenAlex
- W2024037956
- Cited by
- 34
- References
- 18
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 3 · 2014: 1 · 2013: 1
- FWCI
- 0.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of the American Association of Gynecologic Laparoscopists (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- endometrioma, myofibroblast proliferation, collagen deposition, type I collagen, endometriosis pathogenesis, endometriosis surgery
- MeSH terms
- Coloring Agents, Endometriosis, Female, Humans, Immunoenzyme Techniques, Metaplasia, Muscle, Smooth, Ovarian Diseases, Retrospective Studies
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