Harvard Medical School, New England Primate Research Center, One Pine Hill Drive, Southborough, MA 01772, USA.
Vet Pathol. 2012 Jul;49(4):636-41. doi: 10.1177/0300985811406890. Epub 2011 Apr 26.
Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is one of the most common reproductive abnormalities encountered in women as well as Old World primates. The majority of endometriosis cases in Old World primates occur within the abdominal cavity, with spread to extraabdominal sites considered to be a rare event. A 19-year-old multiparous female rhesus macaque (Macaca mulatta) presented to necropsy for difficulty breathing and weight loss. Grossly, the animal had marked abdominal endometriosis and severe hemoabdomen and hemothorax, the latter of which was accompanied by marked pleural fibrosis. Histologic examination confirmed the abdominal endometriosis and also revealed numerous uterine glands and stroma embedded within the pleural fibrosis. Rafts of endometrial tissue were present within pulmonary lymphatics and the tracheobronchial lymph nodes. Immunohistochemically, all ectopic endometrial tissue had varying degrees of positive immunoreactivity to cytokeratin, vimentin, progesterone and estrogen receptors, and calretinin but was negative for desmin and carcinoembryonic antigen. Pleural endometriosis is an extremely rare manifestation of endometriosis in nonhuman primates. This case report emphasizes lymphatic spread as a likely mechanism for extrauterine endometriosis.
子宫内膜异位症定义为子宫内膜组织出现在子宫腔外，是女性和旧世界灵长类动物中最常见的生殖系统异常之一。旧世界灵长类动物中的大多数子宫内膜异位症病例发生在腹腔内，而播散至腹腔外部位被认为是罕见事件。一只 19 岁的多产雌性恒河猴（Macaca mulatta）因呼吸困难和体重减轻而接受剖检。大体上，该动物患有明显的腹腔子宫内膜异位症和严重的血性腹水和血胸，后者伴有明显的胸膜纤维化。组织学检查证实了腹腔内的子宫内膜异位症，还发现了许多嵌入胸膜纤维化中的子宫腺体和基质。子宫内膜组织筏存在于肺淋巴管和气管支气管淋巴结中。免疫组织化学染色显示，所有异位子宫内膜组织对细胞角蛋白、波形蛋白、孕激素和雌激素受体以及钙视网膜蛋白均有不同程度的阳性免疫反应，但对结蛋白和癌胚抗原呈阴性。胸膜子宫内膜异位症是灵长类动物中极为罕见的子宫内膜异位症表现。本病例报告强调了淋巴扩散是子宫外子宫内膜异位症的可能机制。
