1. Lymphatic spread of endometriosis to pelvic sentinel lymph nodes: a prospective clinical study.
- Author
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Tempfer CB, Wenzl R, Horvat R, Grimm C, Polterauer S, Buerkle B, Reinthaller A, and Huber JC
- Subjects
- Adult, Coloring Agents pharmacokinetics, Female, Frozen Sections, Humans, Peritoneal Diseases epidemiology, Peritoneal Diseases pathology, Prevalence, Prospective Studies, Sentinel Lymph Node Biopsy statistics & numerical data, Severity of Illness Index, Endometriosis epidemiology, Endometriosis pathology, Lymph Nodes pathology, Ovarian Diseases epidemiology, Ovarian Diseases pathology
- Abstract
Objective: To establish the prevalence of endometriosis metastatic to pelvic sentinel lymph nodes (PSLN) in women with ovarian and/or peritoneal endometriosis., Design: Prospective clinical study., Setting: Academic research institution., Patient(s): Women with a laparoscopic diagnosis of ovarian and/or peritoneal endometriosis verified by intraoperative frozen section analysis., Intervention(s): Resection of endometriotic lesions and PSLN after cervical blue dye injection., Main Outcome Measure(s): Histologic analysis of PSLN for the presence of endometriosis and immunohistochemical analysis of estrogen receptor (ER), progesterone receptor (PR), cytokeratin (CK), and CD-10 expression., Result(s): The study enrolled 26 women with suspected endometriosis; endometriosis was confirmed in 23 women, and a PSLN was identified in 19 women. A total of 37 (right side: 20; left side: 17) lymph nodes were removed. The prevalence of endometriotic lesions in PSLN was 11% (2 of 19). Both lesions were positive for ER, PR, CK, and CD-10. Isolated endometriotic-like cells (IELCs) staining positive for ER and PR were identified in the peripheral sinus of 16 (80%) of 20 and 14 (70%) of 20 PSLN, respectively. All IELCs lacked CK staining, whereas CD-10 staining was present in 16 (80%) of 20 cases, indicating a stromal origin of IELCs. Intraoperative and/or postoperative complications were observed in 1 (5%) of 19 women., Conclusion(s): Spread of IELCs to PSLN is common in ovarian and/or peritoneal endometriosis. Metastatic lesions in PSLN are present in 11% of women. Further studies to evaluate the prognostic and predictive value of endometriotic spread to PSLN are warranted., (Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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