Endometriosis: Three-year histopathological perspective from the largest hospital in Africa
Thembi Mashele1, Yavini Reddy2, Sugeshnee Pather1
1Division of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa.
Background:
Endometriosis refers to the presence of ectopic endometrial tissue outside the uterus, that may result in infertility or recurrent implantation failure.
Aims:
We aimed to document the number of histopathologically confirmed cases of endometriosis at the largest hospital in Africa during a three-year timeframe. Age, topographic site, pathological components, CD10 immunohistochemistry, metaplasia and associated neoplasms were documented.
Method:
A retrospective, descriptive cross-sectional review of confirmed cases of endometriosis was conducted.
Results:
Thirty-four (n = 34) patients were confirmed to have endometriosis within 43 topographic sites. More than one topographic site of involvement was documented in 5 patients. The age range was 24 to 58 years [median age 36.4 ± 8.03; mean 34.5 ± 8.03 yrs]. The most frequent diagnostic combination was the triad of endometrial glands, stroma and chronic haemorrhage as confirmed in 53% of the cases. The most frequent topographic site of involvement was the ovary (27.9%) followed by the fallopian tubes (16.7%), umbilical region (13.9%), and abdominal wall (11.6%). Endometriotic cyst was reported in 10 cases (29.4%) and the ovary was the most common site in which endometriotic cysts occurred (p < .01). Endometrioma was only confirmed at the abdominal wall of one patient. CD10 immunochemistry was requested in 5 cases and confirmed the presence of endometrial stroma in all cases tested. Ciliated metaplasia was common (62%). Endometriosis was documented incidentally in context of two cases of neoplasia (pre-invasive and invasive).
Conclusion:
Endometriosis is diagnosed predominantly, but not exclusively, in women of child-bearing age. Ovarian involvement has a propensity to develop endometriotic cysts. CD10 immunohistochemistry has diagnostic value when endometrial stroma is limited or inconspicuous.
