Peritoneal Endometriosis: Two‐Dimensional and Three‐Dimensional Evaluation of Typical and Subtle Lesionsa

Jacques Donnez, Donnez J, J Donnez, Nisolle M, Michelle Nisolle, M Nisolle, Casanas-Roux F, Françoise Casanas‐Roux, F Casanas-Roux
Annals of the New York Academy of Sciences · 1994 · vol. 734(1) , pp. 342–351 · doi:10.1111/j.1749-6632.1994.tb21764.x · PMID:7978936 · W2098764661
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This study investigated how surgeons' experience and biopsy confirmation improved the detection of subtle, nonpigmented peritoneal endometriosis lesions during laparoscopy.

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This paper examines peritoneal endometriosis lesions using two-dimensional and three-dimensional evaluation to characterize both typical pigmented lesions and “subtle” nonpigmented appearances that may be missed at laparoscopy. The authors describe that improved laparoscopic diagnosis is partly due to increased surgeon experience, with subtle lesion detection rising markedly over the late 1980s, and they report that nonpigmented lesions were diagnosed as endometriosis after biopsy confirmation. The key finding is the existence of numerous subtle peritoneal endometriosis appearances beyond the commonly recognized puckered black or bluish lesions, with biopsy serving as the confirmation step. This paper is centrally about endometriosis — specifically the two- and three-dimensional assessment of typical versus subtle peritoneal lesions in endometriosis.

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Abstract

Endometriosis most commonly affects the pelvic peritoneum close to the ovaries, including the uterosacral ligaments, the ovarian fossa peritoneum, and the perito- neum of the cul-de-sac.\nThe increased diagnosis of endometriosis at laparoscopy can be explained by the increased experience and ability of the surgeon to detect such subtle lesions. The greatest change has been in the case of “subtle” lesions, which increased from 15% in 1986 to 65% in 1988. The diagnosis of peritoneal endometriosis at the time of laparoscopy is often made by the observation of typically puckered black or bluish lesions. There are, in addition, numerous subtle appearances of peritoneal endometriosis.\nThese lesions, frequently nonpigmented, were diagnosed as endometriosis following confirmation by biopsy by Jansen and Russell in 1986.
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Article (Scientific journals) Peritoneal endometriosis: two-dimensional and three-dimensional evaluation of typical and subtle lesions. ; ; 1994 • In Annals of the New York Academy of Sciences, 734 Peer Reviewed verified by ORBiDonnez J anyas 1994.x.pdf Publisher postprint (1.11 MB) All documents in ORBi are protected by a user license. copy to clipboard copied Abstract : [en] Endometriosis most commonly affects the pelvic peritoneum close to the ovaries, including the uterosacral ligaments, the ovarian fossa peritoneum, and the perito- neum of the cul-de-sac. The increased diagnosis of endometriosis at laparoscopy can be explained by the increased experience and ability of the surgeon to detect such subtle lesions. The greatest change has been in the case of “subtle” lesions, which increased from 15% in 1986 to 65% in 1988. The diagnosis of peritoneal endometriosis at the time of laparoscopy is often made by the observation of typically puckered black or bluish lesions. There are, in addition, numerous subtle appearances of peritoneal endometriosis. These lesions, frequently nonpigmented, were diagnosed as endometriosis following confirmation by biopsy by Jansen and Russell in 1986. Disciplines : Reproductive medicine (gynecology, andrology, obstetrics) Donnez, Jacques NISOLLE, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR Casanas-Roux, Françoise Language : English Title : Peritoneal endometriosis: two-dimensional and three-dimensional evaluation of typical and subtle lesions. Publication date : 1994 Journal title : Annals of the New York Academy of Sciences ISSN : 0077-8923 eISSN : 1749-6632 Publisher : New York Academy of Sciences, New York, United States - New York Volume : 734 Peer reviewed : Peer Reviewed verified by ORBi Available on ORBi : since 16 November 2011 Scopus citations® 11 Scopus citations® without self-citations without self-citations 8 OpenCitations 5 OpenAlex citations 9 - Bergqvist A., Rannevik G., Thorell J. (1981) Estrogen and progesterone cytosol receptor concentration in endometriotic tissue and intrauterine endometrium. Acta Obstet. Gynecol. Scand. 101:53-58. - Braverman M.S., Braverman I.M. (1986) Three‐dimensional reconstructions of objects from serial sections using a microcomputer graphic system. J. Invest. Dermatol. 86:290-294. - Brosens I., Vasquez G., Gordts S. (1984) Scanning electron microscopic study of the pelvic peritoneum in unexplained infertility and endometriosis. Fertil. Steril. 41:215. - Chatman D.L. (1981) Pelvic peritoneal defects and endometriosis; Allen‐Masters syndrome revisited. Fertil. Steril. 36:751. - Donnez J., Nisolle M., Casanas‐Roux F. (1992) Three‐dimensional architectures of peritoneal endometriosis. Fertil. Steril. 57:980. - Ito M., Yokoyama H., Ikeda K., Sat. Y. (1990) Stereographic analysis of syringomas. Arch. Dermatol. Res. 282:17-21. - Janne O., Kauppila A., Kokko E. (1981) Estrogen and progestin receptors in endometriosis lesions: comparison with endometrial tissue. Am. J. Obstet. Gynecol. 141:562-566. - Jansen R.P.S., Russell P. (1986) Nonpigmented endometriosis: clinical laparoscopic and pathologic definition. Am. J. Obstet. Gynecol. 155:1154. - Lox C.D., Word L., Heine M.W. (1984) Ultrastructural evaluation of endometriosis. Fertil. Steril. 41:755. - Marchevsky A.M., Gil J., Jeanty H. (1987) Computerized interactive morphometry in pathology: current instrumentation and methods. Hum. Pathol. 18:320-331. - Martin D.C., Hubert G.D., Zwaag, El‐Zeky F. (1989) Laparoscopic appearances of peritoneal endometriosis. Fertil. Steril. 51:63. - Matta W.H.M., Stabille I., Shaw R.S., Campbell S. (1988) Doppler assessment of uterine blood flow changes in patients with fibroids receiving the GnRH agonist Buserelin. Fertil. Steril. 49:1083. - Murphy A.A., Green W.R., Bobbie D., de la Cruz Z.C., Rock J.A. (1986) Unsuspected endometriosis documented by scanning electron microscopy in visually normal peritoneum. Fertil. Steril. 46:522. - Nisolle M., Casanas‐Roux F., Donnez J. (1988) Histologic study of ovarian endometriosis after hormonal therapy. Fertil. Steril. 49:423. - Nisolle M., Paindaveine B., Bourdon A., Berlière M., Casanas‐Roux F., Donnez J. (1990) Histologic study of peritoneal endometriosis in infertile women. Fertil. Steril. 53:984-988. - Nisolle M., Casanas‐Roux F., Anaf V., Mine J.M., Donnez J. (1993) Morphometric study of the stromal vascularization in peritoneal endometriosis. Fertil. Steril. 59:681. - Redwine D.B. (1987) The distribution of endometriosis in the pelvis by age groups and fertility. Fertil. Steril. 47:173-175. - Roddick J.W., Conkey G., Jacobs E.J. (1960) The hormonal response of endometriotic implants and its relationship to symptomatology. Am. J. Obstet. Gynecol. 79:1173-1177. - Stripling M.C., Martin D.C., Chatman D.L., Vander Zwaag R., Poston W.M. (1988) Subtle appearances of pelvic endometriosis. Fertil. Steril. 49:427. - Tamaya T., Motoyaha T., Ohono Y. (1979) Steroid receptor levels and histology of endometriosis and adenomyosis. Fertil. Steril. 31:394-400.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Peritoneum Biopsy Computer Simulation Endometriosis Endometrium Endometrium Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Models, Anatomic Peritoneum

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