Laparoscopic and histologic 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.g004 · W6960698748
other OA: green CC0
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This retracted observational study investigated the potential role of lymphatic vessels in endometriosis dissemination by observing dye diffusion during laparoscopic tubal patency tests. Researchers noted that methylene blue permeated clustered areas of the uterus and stained connective tissue beneath the round ligament, prompting biopsies that revealed adenomyosis with ectatic lymphatic vessels. Immunostaining for CD34 and podoplanin confirmed the identity of these dilated vessels as lymphatics. Relevance to endometriosis: The paper is centrally about endometriosis, specifically proposing a mechanism involving lymphatic dissemination, while also documenting histological findings of adenomyosis.

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Abstract

Clustered areas of the uterus were permeated by the methylene blue during a dye test that showed bilateral permeability of the tubes (A). After opening the peritoneum of the anterior broad ligament, a blue staining of the connective tissue beneath the round ligament (*) was found (B). In this case, a deep biopsy of the uterine wall where the color changed was taken and adenomyosis with ectatic lymphatic vessels was demonstrated. Deparaffinized 4-μm sections were immunostained with antibodies against CD34 and podoplanin (C and D, respectively) to confirm that the ectatic vessels were lymphatics.
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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 4 Laparoscopic and histologic images. Clustered areas of the uterus were permeated by the methylene blue during a dye test that showed bilateral permeability of the tubes (A). After opening the peritoneum of the anterior broad ligament, a blue staining of the connective tissue beneath the round ligament (*) was found (B). In this case, a deep biopsy of the uterine wall where the color changed was taken and adenomyosis with ectatic lymphatic vessels was demonstrated. Deparaffinized 4-μm sections were immunostained with antibodies against CD34 and podoplanin (C and D, respectively) to confirm that the ectatic vessels were lymphatics.

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