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. 2021 May 7;57(5):453.
doi: 10.3390/medicina57050453.

Clinical and Pathological Significance of Cellular Atypia in Endometriosis

Ioana Maria Maier  1 , Adrian Cornel Maier  2 , Andrada Crișan  1 , Lucian Puşcaşiu  3
Affiliations

Clinical and Pathological Significance of Cellular Atypia in Endometriosis

Ioana Maria Maier et al. Medicina (Kaunas). .

Abstract

Objective: To highlight the most frequent localization of ovarian endometriosis, the presence of atypical endometriosis, and recurrences. Retrospective review of 259 patients diagnosed with ovarian endometriosis treated at Tîrgu-Mures Emergency County Hospital, Obstetric Gynecology Clinic, between January 2014 and December 2018. Methods: Data were collected and analyzed for demographics, size of ovarian endometriotic cyst, and recurrences. Results: Out of 259 patients, 51 patients presented atypia, 20 on the right, 24 on the left, and seven patients were diagnosed with endometriosis with bilateral atypia. Higher susceptibility for left localization was noted. Thirty-nine patients (15.1%) presented recurrence. A statistically significant correlation (p = 0.006) was noted between patients with recurrence and atypia compared with those without atypia and endometriotic cysts larger than 7 cm. Patients with relapse under the age of 40 were noted to have mainly atypia with localization on the right (p = 0.025, OD = 4.107). Conclusions: The presence of endometrioma was not statistically significant correlated with left or right sided localization; recurrent endometriomas larger than 7 cm represents a risk for atypical endometriosis development. Recurrence and atypia appear more often in patients under the age of 40 and are right-sided. The total removal of the endometriomas can prevent the recurrence and subsequently the appearance of atypia and secondary neoplastic conditions.

Keywords: atypical endometriosis; endometriosis; endometriotic cysts.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Area of endometriotic cyst showing epithelial lining with larger nuclei, pleomorphism, and high nuclear to cytopalmatic ratio, consistent with atypical endometriosis.
Figure 2
Figure 2
Cellular crowding in the lining of endometriotic cyst and markedly pigmented hemosiderin-laden macrophages.
Figure 3
Figure 3
Stratification in the lining of an endometriotic cyst.
See this image and copyright information in PMC

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