Skip to main content

Tumor-Like Lesions and Endometriosis, Pathology of the Peritoneum

  • Living reference work entry
  • First Online:
Encyclopedia of Pathology

Part of the book series: Encyclopedia of Pathology ((EP))

  • 6 Accesses

Endosalpingiosis

Definition

Ectopic fallopian tube epithelium.

Clinical Features

  • Incidence

    13%. Frequently occurs in association with ovarian serous borderline tumors and low-grade serous carcinoma.

  • Age

    Wide age range, but more commonly found in women of reproductive age.

  • Sex

    Female.

  • Site

    Peritoneum, pelvic soft tissue, and lymph nodes.

  • Treatment

    Usually an incidental finding at surgery for other indications.

  • Outcome

    This is a benign lesion.

Macroscopy

Not typically grossly appreciable. When presenting as florid cystic endosalpingiosis, it rarely forms a mass lesion.

Microscopy

Simple glands lined by a single layer of serous-type epithelium containing peg cells and ciliated cells. Intraglandular stromal projections forming simple papillae may be present (Fig. 1).

Fig. 1
figure 1

Simple glands with tubal-type epithelium. Note the presence of ciliated cells and peg cells

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References and Further Reading

  • Anglesio, M. S., Papadopoulos, N., Ayhan, A., Nazeran, T. M., Noe, M., Horlings, H. M., Lum, A., et al. (2017). Cancer-associated mutations in endometriosis without cancer. The New England Journal of Medicine, 376, 1835–1848.

    Article  PubMed  PubMed Central  Google Scholar 

  • Anrique, D., Anton, A., Kruger, K., Niedobitek-Kreuter, G., & Ebert, A. D. (2013). Splenosis: An uncommon differential diagnosis in gynecology. Journal of Minimally Invasive Gynecology, 20, 708–709.

    Article  PubMed  Google Scholar 

  • Ayhan, A., Mao, T. L., Seckin, T., Wu, C. H., Guan, B., Ogawa, H., Futagami, M., et al. (2012). Loss of ARID1A expression is an early molecular event in tumor progression from ovarian endometriotic cyst to clear cell and endometrioid carcinoma. The International Journal of Gynecological Cancer, 22, 1310–1315.

    Article  PubMed  Google Scholar 

  • Baker, P. M., Clement, P. B., & Young, R. H. (2005). Malignant peritoneal mesothelioma in women: A study of 75 cases with emphasis on their morphologic spectrum and differential diagnosis. American Journal of Clinical Pathology, 123, 724–737.

    Article  PubMed  Google Scholar 

  • Boyle, D. P., & McCluggage, W. G. (2009). Peritoneal stromal endometriosis: A detailed morphological analysis of a large series of cases of a common and under-recognised form of endometriosis. Journal of Clinical Pathology, 62, 530–533.

    Article  CAS  PubMed  Google Scholar 

  • Carvalho, L., Podgaec, S., Bellodi-Privato, M., Falcone, T., & Abrao, M. S. (2011). Role of eutopic endometrium in pelvic endometriosis. Journal of Minimally Invasive Gynecology, 18, 419–427.

    Article  PubMed  Google Scholar 

  • Chapel, D. B., Husain, A. N., Krausz, T., & McGregor, S. M. (2017). PAX8 expression in a subset of malignant peritoneal mesotheliomas and benign mesothelium has diagnostic implications in the differential diagnosis of ovarian serous carcinoma. The American Journal of Surgical Pathology, 41, 1675–1682.

    Article  PubMed  Google Scholar 

  • Charatsi, D., Koukoura, O., Ntavela, I. G., Chintziou, F., Gkorila, G., Tsagkoulis, M., Mikos, T., et al. (2018). Gastrointestinal and urinary tract endometriosis: A review on the commonest locations of extrapelvic endometriosis. Advances in Medical Education and Practice, 2018, 3461209.

    Google Scholar 

  • Chikkamuniyappa, S., Herrick, J., & Jagirdar, J. S. (2004). Nodular histiocytic/mesothelial hyperplasia: A potential pitfall. Annals of Diagnostic Pathology, 8, 115–120.

    Article  PubMed  Google Scholar 

  • Chui, M. H., & Shih, I. M. (2020). Oncogenic BRAF and KRAS mutations in endosalpingiosis. The Journal of Pathology, 250, 148–158.

    Article  CAS  PubMed  Google Scholar 

  • Churg, A., Sheffield, B. S., & Galateau-Salle, F. (2016). New markers for separating benign from malignant mesothelial proliferations: Are we there yet? Archives of Pathology & Laboratory Medicine, 140, 318–321.

    Article  CAS  Google Scholar 

  • Clement, P. B. (2007). The pathology of endometriosis: A survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Advances in Anatomic Pathology, 14, 241–260.

    Article  PubMed  Google Scholar 

  • Clement, P. B., & Young, R. H. (1993). Florid mesothelial hyperplasia associated with ovarian tumors: A potential source of error in tumor diagnosis and staging. International Journal of Gynecological Pathology, 12, 51–58.

    Article  CAS  PubMed  Google Scholar 

  • Clement, P. B., & Young, R. H. (1999). Florid cystic endosalpingiosis with tumor-like manifestations: A report of four cases including the first reported cases of transmural endosalpingiosis of the uterus. The American Journal of Surgical Pathology, 23, 166–175.

    Article  CAS  PubMed  Google Scholar 

  • Davis, A. C., & Goldberg, J. M. (2017). Extrapelvic endometriosis. Seminars in Reproductive Medicine, 35, 98–101.

    PubMed  Google Scholar 

  • Disanto, M. G., Mercalli, F., Palicelli, A., Arnulfo, A., & Boldorini, R. (2017). A unique case of bilateral ovarian splenosis and review of the literature. APMIS, 125, 844–848.

    Article  CAS  PubMed  Google Scholar 

  • Djordjevic, B., & Malpica, A. (2012). Ovarian serous tumors of low malignant potential with nodal low-grade serous carcinoma. The American Journal of Surgical Pathology, 36, 955–963.

    Article  PubMed  Google Scholar 

  • Egan, A. J., & Russell, P. (1996). Transitional (urothelial) cell metaplasia of the fallopian tube mucosa: Morphological assessment of three cases. International Journal of Gynecological Pathology, 15, 72–76.

    Article  CAS  PubMed  Google Scholar 

  • Esselen, K. M., Terry, K. L., Samuel, A., Elias, K. M., Davis, M., Welch, W. R., Muto, M. G., et al. (2016). Endosalpingiosis: More than just an incidental finding at the time of gynecologic surgery? Gynecologic Oncology, 142, 255–260.

    Article  PubMed  Google Scholar 

  • Fukunaga, M., & Ushigome, S. (1998). Epithelial metaplastic changes in ovarian endometriosis. Modern Pathology, 11, 784–788.

    CAS  PubMed  Google Scholar 

  • Fukunaga, M., Nomura, K., Ishikawa, E., & Ushigome, S. (1997). Ovarian atypical endometriosis: Its close association with malignant epithelial tumours. Histopathology, 30, 249–255.

    Article  CAS  PubMed  Google Scholar 

  • Gerber, D., Frey, M. K., & Caputo, T. A. (2015). Pelvic splenosis misdiagnosed as a uterine sarcoma. Gynecologic Oncology Reports, 12, 1–2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harrison, B. T., & Mittal, K. (2015). Morphologic features suggestive of endometriosis in nondiagnostic peritoneal biopsies. International Journal of Gynecological Pathology, 34, 507–516.

    Article  PubMed  Google Scholar 

  • Khan, K. N., Fujishita, A., Kitajima, M., Hiraki, K., Nakashima, M., & Masuzaki, H. (2014). Occult microscopic endometriosis: Undetectable by laparoscopy in normal peritoneum. Human Reproduction, 29, 462–472.

    Article  PubMed  Google Scholar 

  • Lameiras, R., Matos, A. P., Luz, C., Palas, J., & Ramalho, M. (2017). Pelvic splenosis-a very unusual location. BJR Case Reports, 3, 20160026.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lemos, A. A., Crespi, S., Costa, S., & Marini, A. (2018). Splenosis of the abdomen and pelvis complicated by torsion of a splenic implant clinically mimicking an acute bowel ischemia. BJR Case Reports, 4, 20180024.

    Article  PubMed  PubMed Central  Google Scholar 

  • Liang, J. J., Malpica, A., & Broaddus, R. R. (2007). Florid cystic endosalpingiosis presenting as an obstructive colon mass mimicking malignancy: Case report and literature review. Journal of Gastrointestinal Cancer, 38, 83–86.

    Article  PubMed  Google Scholar 

  • Lier, M. C. I., Brosens, I. A., Mijatovic, V., Habiba, M., & Benagiano, G. (2017). Decidual bleeding as a cause of spontaneous hemoperitoneum in pregnancy and risk of preterm birth. Gynecologic and Obstetric Investigation, 82, 313–321.

    Article  PubMed  Google Scholar 

  • Lv, Y., Li, P., Zheng, J., Wang, L., Yun, J., Huang, G., Yan, Q., et al. (2012). Nodular histiocytic aggregates in the greater omentum of patients with ovarian cancer. International Journal of Surgical Pathology, 20, 178–184.

    Article  PubMed  Google Scholar 

  • Malpica, A., Deavers, M. T., & Shahab, I. (2002). Gross deciduosis peritonei obstructing labor: A case report and review of the literature. International Journal of Gynecological Pathology, 21, 273–275.

    Article  PubMed  Google Scholar 

  • Markou, G. A., Goubin-Versini, I., Carbunaru, O. M., Karatzios, C., Muray, J. M., & Fysekidis, M. (2016). Macroscopic deciduosis in pregnancy is finally a common entity. European Journal of Obstetrics & Gynecology and Reproductive Biology, 197, 54–58.

    Article  Google Scholar 

  • Matias-Guiu, X., & Stewart, C. J. R. (2018). Endometriosis-associated ovarian neoplasia. Pathology, 50, 190–204.

    Article  PubMed  Google Scholar 

  • McCluggage, W. G. (2020). Endometriosis-related pathology: A discussion of selected uncommon benign, premalignant and malignant lesions. Histopathology, 76, 76–92.

    Article  PubMed  Google Scholar 

  • Michal, M., Kazakov, D. V., Dundr, P., Peckova, K., Agaimy, A., Kutzner, H., Havlicek, F., et al. (2016). Histiocytosis with raisinoid nuclei: A unifying concept for lesions reported under different names as nodular mesothelial/histiocytic hyperplasia, mesothelial/monocytic incidental cardiac excrescences, intralymphatic histiocytosis, and others: A report of 50 cases. The American Journal of Surgical Pathology, 40, 1507–1516.

    Article  PubMed  Google Scholar 

  • Naik, M. A., & Pai, S. A. (2020). Leydig cells in the fallopian tube and Walthard cell nests in the ovary: Heterotopia or Eutopia? International Journal of Gynecological Pathology, 39, e11–e12.

    Article  PubMed  Google Scholar 

  • Oparka, R., McCluggage, W. G., & Herrington, C. S. (2011). Peritoneal mesothelial hyperplasia associated with gynaecological disease: A potential diagnostic pitfall that is commonly associated with endometriosis. Journal of Clinical Pathology, 64, 313–318.

    Article  PubMed  Google Scholar 

  • Parker, R. L., Dadmanesh, F., Young, R. H., & Clement, P. B. (2004). Polypoid endometriosis: A clinicopathologic analysis of 24 cases and a review of the literature. The American Journal of Surgical Pathology, 28, 285–297.

    Article  PubMed  Google Scholar 

  • Pizzi, M., Valentini, E., Galligioni, A., Cesaro, S., Pontisso, P., Da Dalt, G., & Rugge, M. (2016). Benign mesothelial cells in lymph nodes and lymphatic spaces associated with ascites. Histology and Histopathology, 31, 747–750.

    CAS  PubMed  Google Scholar 

  • Possover, M., Schneider, T., & Henle, K. P. (2011). Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus. Fertility and Sterility, 95, 756–758.

    Article  PubMed  Google Scholar 

  • Rabban, J. T., Crawford, B., Chen, L. M., Powell, C. B., & Zaloudek, C. J. (2009). Transitional cell metaplasia of fallopian tube fimbriae: A potential mimic of early tubal carcinoma in risk reduction salpingo-oophorectomies from women with BRCA mutations. The American Journal of Surgical Pathology, 33, 111–119.

    Article  PubMed  Google Scholar 

  • Rapisarda, A. M. C., Cianci, A., Caruso, S., Vitale, S. G., Valenti, G., Piombino, E., & Cianci, S. (2018). Benign multicystic mesothelioma and peritoneal inclusion cysts: Are they the same clinical and histopathological entities? A systematic review to find an evidence-based management. Archives of Gynecology and Obstetrics, 297, 1353–1375.

    Article  PubMed  Google Scholar 

  • Rivas, E., Perry, T., Gray, M., & Tawfik, O. (2018). Cul-de-sac splenosis – An unusual location. Journal of Modern Human Pathology, 3, 12–14.

    Article  Google Scholar 

  • Roma, A. A., & Masand, R. P. (2014). Ovarian Brenner tumors and Walthard nests: A histologic and immunohistochemical study. Human Pathology, 45, 2417–2422.

    Article  CAS  PubMed  Google Scholar 

  • Sah, S., Fulmali, R., & McCluggage, W. G. (2020). Low-grade serous carcinoma arising in inguinal nodal endosalpingiosis: Report of 2 cases and literature review. International Journal of Gynecological Pathology, 39, 273–278.

    Article  PubMed  Google Scholar 

  • Seidman, J. D., Yemelyanova, A., Zaino, R. J., & Kurman, R. J. (2011). The fallopian tube-peritoneal junction: A potential site of carcinogenesis. International Journal of Gynecological Pathology, 30, 4–11.

    Article  PubMed  Google Scholar 

  • Stewart, C. J. (2013). Deciduoid mesothelial hyperplasia of the pelvic peritoneum. Histopathology, 63, 598–600.

    PubMed  Google Scholar 

  • Stewart, C. J., & Bharat, C. (2016). Clinicopathological and immunohistological features of polypoid endometriosis. Histopathology, 68, 398–404.

    Article  PubMed  Google Scholar 

  • Stojanovic, M., Brasanac, D., & Stojicic, M. (2013). Cutaneous inguinal scar endosalpingiosis and endometriosis: Case report with review of literature. The American Journal of Dermatopathology, 35, 254–260.

    Article  PubMed  Google Scholar 

  • Sumathi, V. P., & McCluggage, W. G. (2002). CD10 is useful in demonstrating endometrial stroma at ectopic sites and in confirming a diagnosis of endometriosis. Journal of Clinical Pathology, 55, 391–392.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tandon, Y. K., Coppa, C. P., & Purysko, A. S. (2018). Splenosis: A great mimicker of neoplastic disease. Abdominal Radiology, 43, 3054–3059.

    Article  PubMed  Google Scholar 

  • Vallerie, A. M., Lerner, J. P., Wright, J. D., & Baxi, L. V. (2009). Peritoneal inclusion cysts: A review. Obstetrical & Gynecological Survey, 64, 321–334.

    Article  Google Scholar 

  • Veldhuis, W. B., Akin, O., Goldman, D., Mironov, S., Mironov, O., Soslow, R. A., Barakat, R. R., et al. (2013). Peritoneal inclusion cysts: Clinical characteristics and imaging features. European Radiology, 23, 1167–1174.

    Article  PubMed  Google Scholar 

  • Wang, Y., Nicholes, K., & Shih, I. M. (2020). The origin and pathogenesis of endometriosis. Annual Review of Pathology, 15, 71–95.

    Article  CAS  PubMed  Google Scholar 

  • Wendel, J. R. H., Wang, X., & Hawkins, S. M. (2018). The endometriotic tumor microenvironment in ovarian cancer. Cancers (Basel), 10, 261. https://doi.org/10.3390/cancers10080261.

    Article  CAS  PubMed  Google Scholar 

  • Wiegand, K. C., Shah, S. P., Al-Agha, O. M., Zhao, Y., Tse, K., Zeng, T., Senz, J., et al. (2010). ARID1A mutations in endometriosis-associated ovarian carcinomas. The New England Journal of Medicine, 363, 1532–1543.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Xing, D., Banet, N., Sharma, R., Vang, R., Ronnett, B. M., & Illei, P. B. (2018). Aberrant Pax-8 expression in well-differentiated papillary mesothelioma and malignant mesothelioma of the peritoneum: A clinicopathologic study. Human Pathology, 72, 160–166.

    Article  CAS  PubMed  Google Scholar 

  • Younan, G., Wills, E., & Hafner, G. (2015). Splenosis: A rare etiology for bowel obstruction-a case report and review of the literature. Case Reports in Surgery, 2015, 890602.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zinsser, K. R., & Wheeler, J. E. (1982). Endosalpingiosis in the omentum: A study of autopsy and surgical material. The American Journal of Surgical Pathology, 6, 109–117.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bojana Djordjevic .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Djordjevic, B. (2023). Tumor-Like Lesions and Endometriosis, Pathology of the Peritoneum. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5679-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28845-1_5679-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28845-1

  • Online ISBN: 978-3-319-28845-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics