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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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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. |
format | Online Article Text |
id | pubmed-8118331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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