VISUAL FINDINGS AND HISTOLOGIC DIAGNOSIS OF PELVIC ENDOMETRIOSIS UNDER LAPAROSCOPY AND LAPAROTOMY

Objective-To assess the diagnostic value of visual findings in the dia gnosis of endometriosis from the histological point of view. Study Des ign-212 specimens from 107 patients with benign (74.8%) or malignant ( 25.2%) disease were obtained by biopsy or resection under laparoscopy (65 patients) or laparotomy (42 patients). Ages ranged from 19 to 62 ( mean age 36.4). Visual findings were classified according to the crite ria established by the Endometriosis Committee of the Japan Society of Obstetrics and Gynecology in 1993. Specimens were stained with hemato xylin-eosin, and 15 cases with periodic acid-Schiff stain or silver im pregnation stain. Results-Among pigmented lesions, endometriosis was f ound in 73.0% of specimens from the pelvic peritoneum and in 56.4% of those from the ovaries. Blueberry spots in the pelvic peritoneum as we ll as ovarian chocolate cysts showed the highest positive rate. In the presence of multiple or complex pigmented lesions of the pelvic area, the rate was still higher (88.6%). Those rates were due to our inclus ion of inaccurate and incomplete biopsy specimens. Endometriosis of no npigmented lesions was found in only 11 patients (12.0%) who also had pigmented lesions and/or adenomyosis. Conclusion-The laparoscopic diag nosis of endometriosis can be made only when multiple complex pigmente d lesions are observed, but, otherwise, histopathological confirmation is necessary.