Dickerson Mary F, Martin Lauren D, Lewis Anne D
Office of Comparative Medicine, University of Utah, Salt Lake City, Utah, USA.
Division of Comparative Medicine, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Oregon, USA.
Comp Med. 2017 Aug 1;67(4):376-380.
Endometriosis is a relatively common condition in women and some populations of adult female rhesus macaques. However, endometriosis with extensive smooth muscle proliferation, as occurs in endomyometrioma and uterus-like mass (ULM), is rare in women. This report describes a case of endometriosis with extensive smooth muscle metaplasia resembling multiple ULM in a 20-y-old female rhesus macaque. During a protocol-related procedure, a large, smooth, globoid, freely moveable mass was palpated in the midabdomen. Ultrasonography revealed a cystic structure from which dark brown fluid was aspirated. During exploratory laparotomy, an 8-cm spherical mass in the greater omentum and 3 additional masses (diameter, 2 to 5 cm) attached to the omentum were excised. Microscopic examination of the masses revealed numerous foci of ectopic endometrial glands and stroma frequently surrounded by bundles of smooth muscle and fibrous connective tissue. The gross and histologic lesions in this macaque bore many similarities to ULM in women. To our knowledge, this case represents the first report of endometriosis resembling a uteruslike mass in a NHP.
子宫内膜异位症在女性以及一些成年雌性恒河猴群体中是一种相对常见的病症。然而,像发生在子宫腺肌瘤和子宫样肿物(ULM)中的伴有广泛平滑肌增生的子宫内膜异位症在女性中较为罕见。本报告描述了一例20岁雌性恒河猴发生的伴有广泛平滑肌化生、类似多个ULM的子宫内膜异位症病例。在一次与实验方案相关的操作过程中,在中腹部触诊到一个大的、光滑的、球状的、可自由移动的肿物。超声检查显示一个囊性结构,从中抽出了深棕色液体。在剖腹探查术中,切除了大网膜上一个8厘米的球形肿物以及附着在大网膜上的另外3个肿物(直径2至5厘米)。对这些肿物进行显微镜检查发现,异位子宫内膜腺体和间质的许多病灶常常被平滑肌束和纤维结缔组织包围。这只猕猴的大体和组织学病变与女性的ULM有许多相似之处。据我们所知,该病例是首例非人灵长类动物中类似子宫样肿物的子宫内膜异位症报告。