Volume 76, Issue 1 pp. 76-92
Review

Endometriosis-related pathology: a discussion of selected uncommon benign, premalignant and malignant lesions

W Glenn McCluggage

Corresponding Author

W Glenn McCluggage

Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK

Address for correspondence: W G McCluggage, Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BA, UK. e-mail: [email protected]

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First published: 17 December 2019
Citations: 67

Abstract

Endometriosis is an extremely common condition and, in most cases, establishing a histological diagnosis is straightforward, although a variety of benign alterations may result in problems with interpretation. In this review, I discuss selected uncommon variants of endometriosis or benign alterations that may result in diagnostic problems. The topics covered include the contentious issue of so-called atypical endometriosis, stromal endometriosis, polypoid endometriosis, and the association of endometriosis with florid mesothelial hyperplasia. The propensity of endometriosis to undergo neoplastic transformation (especially to endometrioid and clear cell carcinoma) is well known. Selected issues relating to the various neoplasms that can arise in endometriosis are discussed, with a particular concentration on unusual variants of endometrioid carcinoma that result in a disproportionately high number of issues in referral practice. The propensity of ovarian endometrioid carcinomas to show an unexpected (‘aberrant’) immunophenotype with positive staining with ‘intestinal’ markers and negative staining with Mullerian markers is also discussed. Uncommon tumour types that may arise in endometriosis, namely seromucinous neoplasms, mesonephric-like carcinomas, and somatically derived yolk sac tumours, are also covered.

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