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Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator

The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphologic...

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Autores principales: Okafor, Okechukwu Charles, Ezemba, Ndubueze, Onyishi, Nnaemeka Thaddeus, Ezike, Kevin Nwabueze
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118331/
https://www.ncbi.nlm.nih.gov/pubmed/33984033
http://dx.doi.org/10.1371/journal.pone.0251385
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author Okafor, Okechukwu Charles
Ezemba, Ndubueze
Onyishi, Nnaemeka Thaddeus
Ezike, Kevin Nwabueze
author_facet Okafor, Okechukwu Charles
Ezemba, Ndubueze
Onyishi, Nnaemeka Thaddeus
Ezike, Kevin Nwabueze
author_sort Okafor, Okechukwu Charles
collection PubMed
description The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P<0.05). In this group, the strength of association is high for the first 4 features (Cramér’s V≥0.5). The presence of ceroid macrophages is shown to be a novel key feature, previously unrecognised as such, for the identification of TE. The presence of any three of four features including endometrioid glands, lymphoid clusters, ceroid macrophages and siderophages is a suggested criterion for the definitive diagnosis of TE.
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spelling pubmed-81183312021-05-24 Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator Okafor, Okechukwu Charles Ezemba, Ndubueze Onyishi, Nnaemeka Thaddeus Ezike, Kevin Nwabueze PLoS One Research Article The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P<0.05). In this group, the strength of association is high for the first 4 features (Cramér’s V≥0.5). The presence of ceroid macrophages is shown to be a novel key feature, previously unrecognised as such, for the identification of TE. The presence of any three of four features including endometrioid glands, lymphoid clusters, ceroid macrophages and siderophages is a suggested criterion for the definitive diagnosis of TE. Public Library of Science 2021-05-13 /pmc/articles/PMC8118331/ /pubmed/33984033 http://dx.doi.org/10.1371/journal.pone.0251385 Text en © 2021 Okafor et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Okafor, Okechukwu Charles
Ezemba, Ndubueze
Onyishi, Nnaemeka Thaddeus
Ezike, Kevin Nwabueze
Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
title Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
title_full Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
title_fullStr Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
title_full_unstemmed Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
title_short Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
title_sort improving the diagnostic recognition of thoracic endometriosis: spotlight on a new histo-morphological indicator
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118331/
https://www.ncbi.nlm.nih.gov/pubmed/33984033
http://dx.doi.org/10.1371/journal.pone.0251385
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