Department of Biochemistry, University of Nairobi, Nairobi 00100, Kenya.
Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University, 35392 Giessen, Germany.
Cells. 2021 Jan 18;10(1):180. doi: 10.3390/cells10010180.
Thoracic endometriosis (TE) is a rare type of endometriosis, where endometrial tissue is found in or around the lungs and is frequent among extra-pelvic endometriosis patients. Catamenial pneumothorax (CP) is the most common form of TE and is characterized by recurrent lung collapses around menstruation. In addition to histology, immunohistochemical evaluation of endometrial implants is used more frequently. In this review, we compared immunohistochemical (CPE) with histological (CPH) characterizations of TE/CP and reevaluated arguments in favor of the implantation theory of Sampson. A summary since the first immunohistochemical description in 1998 until 2019 is provided. The emphasis was on classification of endometrial implants into glands, stroma, and both together. The most remarkable finding is the very high percentage of stromal endometriosis of 52.7% (CPE) compared to 10.2% (CPH). Chest pain, dyspnea, right-sided preference, and diaphragmatic endometrial implants showed the highest percentages in both groups. No significant association was found between the recurrence rate and the various appearances of endometriosis. Sometimes in CPE (6.8%) and CPH (30.6%) no endometrial implants were identified underlining the importance of sensitive detection of endometriosis during and after surgery. We suggest that immunohistochemical evaluation should become mandatory and will improve diagnosis and classification of the disease.
胸腔子宫内膜异位症（TE）是一种罕见的子宫内膜异位症，其特征是肺部或其周围有子宫内膜组织，且多见于盆腔外子宫内膜异位症患者。月经性气胸（CP）是 TE 最常见的形式，其特征是在月经期间反复发生肺萎陷。除了组织学，免疫组织化学评估子宫内膜植入物的应用也越来越频繁。在这篇综述中，我们比较了 TE/CP 的免疫组织化学（CPE）和组织学（CPH）特征，并重新评估了 Sampson 植入理论的论据。提供了自 1998 年首次免疫组织化学描述以来至 2019 年的总结。重点是将子宫内膜植入物分类为腺体、基质和两者的组合。最显著的发现是基质子宫内膜异位症的比例非常高，为 52.7%（CPE），而组织学为 10.2%（CPH）。在两组中，胸痛、呼吸困难、右侧偏好和膈膜子宫内膜植入物的比例均最高。复发率与各种子宫内膜异位症表现之间没有发现显著关联。有时在 CPE（6.8%）和 CPH（30.6%）中没有发现子宫内膜植入物，这强调了在手术期间和之后敏感检测子宫内膜异位症的重要性。我们建议免疫组织化学评估应成为强制性的，并将改善疾病的诊断和分类。
