Thoracic endometriosis: Pathogenesis, epidemiology, and pathology
- Jose Joseph-Vempilly, MD
Jose Joseph-Vempilly, MD
- Professor of Medicine
- UCSF, Fresno
Endometriosis most commonly involves the pelvis, particularly the ovaries, cul-de-sac, broad ligaments, and uterosacral ligaments. However, endometrial tissue can be found outside of the pelvis in the abdomen, thorax, brain, and skin . Thoracic involvement is the most frequent extra-pelvic location of endometriosis .
The pathogenesis, epidemiology, and pathology of thoracic endometriosis will be reviewed here. Details regarding the clinical presentation, diagnosis, and treatment of thoracic and pelvic endometriosis are discussed separately. (See "Clinical features, diagnostic approach, and treatment of adults with thoracic endometriosis" and "Endometriosis: Pathogenesis, clinical features, and diagnosis" and "Endometriosis: Treatment of pelvic pain".)
Endometriosis is defined as the presence of ectopic endometrial tissue (glands and stroma) outside the confines of the uterine cavity and musculature. Thoracic endometriosis involves components of the thoracic cavity (eg, pleura, parenchyma, diaphragm, bronchus). The following terms apply:
Thoracic endometriosis — The term "thoracic" endometriosis is used when endometrial tissue is identified on histological specimens (hormone receptor-positive endometrial stroma and glands) obtained from chest tube aspirate, thoracotomy, or bronchoscopy.
Probable thoracic endometriosis — The term "probable" thoracic endometriosis refers to the identification of tissue within the thorax that is suggestive but not definitively diagnostic of endometrium (eg, stroma only or hormone receptor-negative tissue) .
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