Laparoscopic images.

Marco Scioscia (6625328), Anna Pesci (8107865), Arnaldo Scardapane (716949), Marco Noventa (689021), Gloria Bonaccorsi (4016579), Pantaleo Greco (375226), Giuseppe Zamboni (8107868)
2019 · doi:10.1371/journal.pone.0226264.g003 · W6960712258
other OA: green CC0
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Methylene blue imaging visualized dye permeation through the uterine wall and lymphatics, while immunohistochemistry demonstrated endometriosis lesions within lateral abdominal wall lymphatic vessels.

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This retracted prospective observational study investigated dye diffusion during laparoscopic tubal patency tests to explore potential lymphatic contributions to endometriosis dissemination. Researchers observed methylene blue permeating the uterine wall and staining lymphatics surrounding the di-utero-ovarian vessels, alongside an immunohistochemically confirmed endometriosis lesion within a lymphatic vessel of the lateral abdominal wall. The paper explicitly states that it has been retracted, which serves as a major caveat regarding the validity of its findings. This paper is centrally about endometriosis, specifically examining the role of lymphatic vessels in the spread of lesions through dye diffusion studies.

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Abstract

The photo sequence (A to D) shows the methylene blue solution that seeped through the tubes and that permeated the uterine wall (A); after a short while, only sub-perimetrial vessels remained dyed (B) and a few seconds later, a clear staining of the lymphatics surrounding di utero-ovarian artery and vein was evident (C). The dye took some minutes to reach the ovary that showed a faint blue color of the cortex beneath the tunica albuginea (D). Photo E shows an endometriosis lesion within a lymphatic vessel of the lateral abdominal wall (the inset at the lower right corner shows a higher magnification thereof) as demonstrated at immunohistochemistry. Two endometriosis foci deeply invaded the peritoneum that lined the right diaphragm (F).
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RETRACTED: Dye diffusion during laparoscopic tubal patency tests may suggest a lymphatic contribution to dissemination in endometriosis: A prospective, observational study Fig 3 The photo sequence (A to D) shows the methylene blue solution that seeped through the tubes and that permeated the uterine wall (A); after a short while, only sub-perimetrial vessels remained dyed (B) and a few seconds later, a clear staining of the lymphatics surrounding di utero-ovarian artery and vein was evident (C). The dye took some minutes to reach the ovary that showed a faint blue color of the cortex beneath the tunica albuginea (D). Photo E shows an endometriosis lesion within a lymphatic vessel of the lateral abdominal wall (the inset at the lower right corner shows a higher magnification thereof) as demonstrated at immunohistochemistry. Two endometriosis foci deeply invaded the peritoneum that lined the right diaphragm (F).

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