1/11. Catamenial pneumothorax caused by diaphragmatic stromal endometriosis.A case of catamenial pneumothorax caused by stromal endometriosis of the diaphragm is described. A 40-year-old woman suffered two episodes of right-sided pneumothorax which occurred after onset of menstruation. thoracoscopy revealed brownish spots in the right diaphragm and partial excision of the diaphragm was performed. Histological examination showed that the lesion was characterized by sheets of cells resembling endometrial stromal cells, small thin-walled blood vessels and extravasated erythrocytes in varying proportions. Some clusters of these cells were transmural. No endometrial-type glands were found. Immunohistochemically, the nuclei of the endometrial stromal cells were strongly positive for both estrogen and progesterone receptors. Therapy with a gonadotropin-releasing hormone analogue was started and the patient has since been asymptomatic for 6 months. Pathologists should not overlook diaphragmatic stromal endometriosis as a possible cause of pneumothorax.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/11. Spontaneous rupture of the uterine vessels in pregnancy.BACKGROUND: hemoperitoneum resulting from spontaneous rupture of the uterine vessels in pregnancy is rare and associated with high maternal and fetal mortality. CASE: A woman presented with acute abdominal pain and hypovolemic shock at 20 weeks of gestation. Immediate laparotomy revealed massive hemoperitoneum resulting from spontaneous rupture of the left uterine vessels associated with a left adnexal mass consisting of decidualized endometriosis. The fetus was delivered by hysterotomy, hemostasis was achieved, and the woman made a good recovery. CONCLUSION: We report a case of hemoperitoneum in pregnancy that resulted from spontaneous rupture of the uterine vessels associated with decidualized endometriosis.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
3/11. Failure of laparoscopy to relieve ureteral obstruction secondary to endometriosis.OBJECTIVES: To present a case of hydronephrosis and hydroureter secondary to pelvic endometriosis and to discuss the pitfalls in laparoscopic management. CASE REPORT: A 37-year-old nulligravida woman had mild elevation of blood pressure for about 1 year without abdominal pain, dyspareunia, or dysmenorrhea. Renal ultrasound revealed left hydronephrosis and a 4-cm pelvic cyst. Intravenous pyelogram showed distal ureteral obstruction. An MRI with fat saturation disclosed a left ovarian endometrioma and a lesion in the uterosacral ligament causing periureteral compression. Laparoscopic findings included a dilated left ureter above the uterosacral ligament, left uterosacral ligament endometriosis with adhesions, and a 4-cm left ovarian endometrioma. Cystoureteroscopy showed external ureteral compression 2 cm above the ureteral orifice. A ureteral catheter was placed. The left endometrioma was enucleated and ureterolysis was performed. The latter procedure had to be discontinued because of bleeding from descending uterine vessels. The ureteral catheter was removed 2 months later and her blood pressure gradually returned to normal. However, after 1 year, she was found to have recurrent hydronephrosis and underwent segmental resection of the distal ureter and reconstruction by end-to-end reanastomosis. CONCLUSION: In women of reproductive age, hydronephrosis and hypertension may be the only symptoms of endometriosis. While laparoscopic treatment is useful in endometriosis, it may fail in the presence of chronic inflammation and severe fibrosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/11. Uterine intravascular menstrual endometrium simulating malignancy.Intravascular menstrual endometrium, a rare finding in hysterectomy specimens, can pose clinically critical differential diagnostic problems. We describe a 28-year-old female with cervical dysplasia and numerous foci of menstrual endometrium in the parametrial blood vessels of her subsequent hysterectomy specimen. Histologically, the intravascular tissue consisted of small spindled stromal cells, larger cuboidal epithelial cells, or both components in close association. Immunohistochemically, the small spindled cells were vimentin positive and the larger cuboidal cells stained with epithelial markers. Distinction of intravascular menstrual endometrium from intravascular malignancies such as carcinoma, sarcoma, or lymphoma may be difficult, especially at the time of frozen-section diagnosis. awareness of this process, attention to its cytologically bland, usually biphasic appearance, knowledge of the menstrual status, and application of appropriate immunohistochemical markers will allow distinction from neoplasia.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/11. The syndrome of palmar fibromatosis (fasciitis) and polyarthritis.A 45-year-old woman developed simultaneously a form of palmar and digital fibromatosis and an unusual polyarticular disorder with painful capsular contraction. The features of the bilateral shoulder involvement were consistent with the adhesive capsulitis/frozen shoulder syndrome. The other affected joints were painfully contracted and tender but without signs of inflammation in synovial fluid (knee) or associated abnormalities in hematologic status. Histologically, there was extensive fibrosis with increased numbers of fibroblasts, dilated blood vessels and scant perivascular lymphocytic infiltration. The clinical and pathological features were similar to cases described as palmar fasciitis and polyarthritis occurring in association with malignant tumors and with antituberculous chemotherapy. Several months after removal of an endometrial cyst of the ovary and after symptomatic treatment, the palmar fibromatosis and polyarticular disorder had almost completely resolved.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/11. Supernumerary ovary with an endometrioma and osseous metaplasia: a case report.A 32-year-old-woman with a history of endometriosis and chronic pelvic pain had left-sided pain and ultrasonographic documentation of a left pelvic complex cyst approximately 5 cm in diameter. laparotomy revealed a left retroperitoneal cystic mass adjacent to the iliopsoas muscle and overlying the major pelvic vessels. The mass was dissected and excised. Histopathologic study revealed endometrioma and osseous metaplasia in a supernumerary ovary.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/11. Endolymphatic stromal myosis: report of a case treated surgically and with hormones.Stromal endolymphatic myosis is regarded as a mixed homologous tumour with a prominent proliferation of the stroma and a varying degree of proliferation of glandlike structures and vessels. A case is presented in which the patient was treated periodically with progestine. This therapy seems to have been of benefit in controlling the frequency of recurrence.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/11. Traumatic hypogastric artery bleeding controlled with bipolar desiccation during operative laparoscopy.During multipuncture operative laparoscopy to excise peritoneal endometriosis involving the pelvic sidewall near the origin of the uterine artery, the lower portion of the hypogastric artery was perforated. The acute hemorrhage was controlled by immediately grasping the lacerated blood vessel with a 5-mm atraumatic grasping forceps. A Kleppinger bipolar forceps set at 25 W desiccated and sealed the artery successfully. As no further bleeding was noted, the procedure was terminated. The patient remained overnight for observation, and was discharged from the hospital the next day. She is doing well 18 months after the injury and repair.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/11. Accidental ovarian autograft after a laparoscopic surgery: case report.OBJECTIVE: To report an autograft of ovarian tissue in the incision of the surgical trocar during laparoscopic surgery and to assess the potentiality of grafting of ovarian parenchyma in nonpelvic tissue in humans. DESIGN: A case report. SETTING: Instituto de Fertilidad y Ginecologia de Buenos Aires (IFER), Buenos Aires, argentina. PATIENT(S): Infertile patient undergoing surgery due to an endometriotic cyst of the left ovary. INTERVENTION(S): Laparoscopic cystectomy. Accidental retention of a portion of the capsule and adjacent ovarian tissue of the endometrioma in SC cellular tissue. Months after surgery, a SC tumor was formed under the surgical incision. It was subsequently excised. MAIN OUTCOME MEASURE(S): observation of tumor growth during menstrual cycles and ovulation induction; anatomopathologic study of the tissue after its extirpation. RESULT(S): The tumor grew spontaneously in the periovulatory period and during treatments of ovulation induction. The anatomopathologic report of the tumor, removed 15 months after the first surgery, revealed functioning ovarian tissue with vessels of neoformation. CONCLUSION(S): This is the first description of autografted ovarian tissue in humans. We describe that the ovary can maintain its ovulatory function even in the absence of its pedicel. Also, we suggest that extirpation of surgical material through the incision of the trocar is not recommended, as the possibility of "sowing" or of autografts may occur.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/11. Intralymphatic embolic cells with cutaneous endometriosis in the umbilicus.endometriosis is defined as the presence of both functioning endometrial glands and stroma outside their usual location lining the uterine cavity. It has been identified in virtually all tissues and organs of the female body with the exception of the spleen. There have been many theories proposed regarding the etiology and pathogenesis of endometriosis. One is the transport of cells through lymphatics and blood vessels. A 44-year-old female suffering from an episode of endometriosis of the umbilicus, left inguinal, uterus, and bilateral ovaries in association with a Mullerian anomaly is presented. Histopathological findings of a skin biopsy from her umbilicus showed aggregated cells within the lymphatic vessel of the upper dermis. This case provides evidence suggesting that cutaneous endometriosis could occur by transport of endometrial cells through lymphatics or blood vessels.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
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