Tannous Andrew M, Bastow Brittney D
Obstetrics and Gynecology, Saint Joseph Hospital, Denver, USA.
Obstetrics and Gynecology, Kaiser Permanente, Denver, USA.
Cureus. 2024 Apr 28;16(4):e59212. doi: 10.7759/cureus.59212. eCollection 2024 Apr.
This paper presents the case of a 28-year-old with a history of chronic pelvic pain suspicious of endometriosis. She underwent a diagnostic laparoscopy and biopsy of lesions along the posterior cul-de-sac and right sidewall near the external iliac artery. Histopathological examination revealed no evidence of endometriosis but did comment on benign lymph node tissue with tattoo-like pigment. These findings correspond to the patient's tattoos located along the lower extremities. It is suspected there was cutaneous tattoo ink migration causing intra-abdominal lymphadenopathy, which visually mimicked endometriosis on diagnostic laparoscopy. Surgeons should become familiar with and recognize this phenomenon, as it can be misleading in the setting of endometriosis and diagnostic laparoscopy. Surgeons undertaking these cases must be able to identify and safely excise abnormal-appearing lesions in many different locations to prevent a missed or delayed diagnosis of endometriosis.
本文介绍了一名28岁有慢性盆腔疼痛病史、怀疑患有子宫内膜异位症的患者。她接受了诊断性腹腔镜检查，并对后穹窿和靠近髂外动脉的右侧壁病变进行了活检。组织病理学检查未发现子宫内膜异位症的证据，但提到了有纹身样色素沉着的良性淋巴结组织。这些发现与患者下肢的纹身相对应。怀疑是皮肤纹身墨水迁移导致腹腔内淋巴结病，在诊断性腹腔镜检查中在视觉上模仿了子宫内膜异位症。外科医生应熟悉并认识到这种现象，因为它在子宫内膜异位症和诊断性腹腔镜检查中可能会产生误导。处理这些病例的外科医生必须能够识别并安全切除许多不同部位外观异常的病变，以防止子宫内膜异位症的漏诊或延迟诊断。
