Features of endometriosis

Macroscopically endometriosis may be in the form of nodes, infiltrates with no clear contours or cystic formations filled with hemorrhagic or thick brown liquid. Unit sizes range from values millet grain up to several centimeters in diameter. In the context of the nodes are visible cavity in the form of cells or crevices filled with hemorrhagic or brown liquid. The consistence of a dense nodes, which is explained by the development centers around and sockets endometritei tissue infiltrative scarring as a result of penetration into tissues menstrualnopodobne bleeding, proteolytic and lipolytic enzymes secreted by the foci of endometriosis, and the products of destruction of tissue, formed in the zone of active endometriosis.
In the area of the isthmus and in the wall of the uterus endometriosis may have a diffuse character, but frequently the foci of endometriosis are observed in the form of nodes or cystic formations. The last (cystic form) usually develop in the ovaries, at least - in the post-operative scars, the navel, the wall of the vagina and the vulva. Rarely, but still observed cystic forms of endometriosis, uterus, fallopian tubes, lungs, kidneys and intestinal wall.
Histological structure of endometriosis is characterized by a combination of glandular endometrioses epithelium and tithenai stroma. As in endometrii cancer may take the form of a tube, branched or small cystic advanced cavities and lined single row cylindrical or cubic epithelium. Part of epithelial cells have cilia. Histological structure of endometriosis, uterine and vaginal wall is presented in Fig. 1, 2.

endometriosis cancer endometriosis vaginal wall
Fig. 1 (left), Endometriosis, uterine (histological preparation); and - in the thickness of the wall of the uterus: b - cystic form

Fig. 2. Endometriosis vaginal wall (histological preparation).

The ratio of glandular elements and stroma in the foci of endometriosis can be different. Sometimes there are primary development of the stroma and the presence of a single endometrial glands or their complete absence. Such forms stromal endometriosis can cause difficulty in diagnosis (mistakenly classified as sarcoma). They tend to be proliferating growth and spread through the lymph system.
Stromal endometriosis can be combined with conventional endometriosis, uterus and other reproductive organs. Known observations combination of genital and stromal extra genital endometriosis (colon, seal).
One of the characteristic features of endometriosis is the lack of a connective tissue capsule around it. This circumstance has to be taken into account during operations for endometriosis. In addition to well-marked and visible to the naked eye, and also palpable foci of endometriosis, infiltrated and scar-modified tissue can be small areas endometritei tissue with low-cyclic transformations. It is from these sites (nodes) in cases of non-radical removal is growth of endometriosis.
Around some of the foci of endometriosis, located in the genitals and beyond, recurrent menstrualnopodobnoe haemorrhage and the consequent inflammatory reaction may form fibrous tissue that resembles a connective tissue capsule. It happens when cystic form of endometriosis light, when there is no drainage connection with bronchus, and typical for this lesion is hemoptysis is not observed. The same may occur in cystic form of endometriosis, ovarian, and in the postoperative scars.
Another peculiarity of endometriosis is its ability to infiltrating penetrating growth in surrounding organs and tissues with the destruction of the last due to the enzymatic activity of endometriosis, the ability to allocate lipolytic and Tripolitania enzymes [B. N. Baskakov, 1966]. Endometriosis can grow into any tissue in any organ: in the wall of the intestine, urinary bladder, ureter, the peritoneum, the pleura, the bone tissue. Ingrowth of endometriosis in the muscle wall of the body (intestines, bladder) is accompanied by a thickening of the walls of the body due to the proliferation of endometrial glands, connective tissue stroma and reactions.

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