Endometriosis of the Abdominal Wall - Clinical, Histopathological and Immunohistochemical Aspects

Endometriosis is a benign gynecological pathology that mostly affects the organs of the pelvis,but also organs located at a distance maybe affected. Tissue immunohistochemically identified as ectopic endometrium may undergo certain structural and functional changes that may lead to preneoplastic alterations (hyperplasia, dysplasia) in normal cellswhich can evolve to neoplasia. Clinical, genetic, metabolic conditions and local factors may influence degenerationof a benign pathology into a malignant pathology. Endometriosis of the abdominal wall is more frequently encountered, as the number of casarean section has increased. Endometriomas surrounding tissue has a direct impact on the structure of the cells that form the mass. By remodeling cellular morphology, corroborated with the hormonal factors action and the inflammatory response ( via lymphocyte cell secretion), the cell cycle is altered and antiapoptotic activity may be promoted. Immune system via lymphocyte cell secretion, the pressure exerted on the tumor area by surrounding tissueswith its size change, conditioned by the fluctuation of hormonal factors, act directly on the cellular structure and can increase anti-apoptotic action and decrease cell cycle regulation. The presence of endometriomas is identified by the positivity of immunohistochemical reactions for estrogen receptors (ER), progesteron receptors (PR), Cytokeratin 7 (CK7) for endometrial tissue. Negative reaction at Cytokeratin 20 (CK20) shows that the studied area is not a metastasis of a digestive tumor. The presence of abundant inflammatory, peritumoral cells markedwith anti-CD68 / Tryptase for macrophages / mast cells demonstrates the involvement of the inflammatory system in the structural and functional modification of endometrial cells.The pronounced cell division was demonstrated by intense reaction with the anti-Ki67 antibody.The signigicant anti-apoptotic action of the endometrial tissue is shown by the positivity of anti-B cell Lymphoma 2 (BCL2) / anti-Phosphatase and tensin homolog (PTEN) / anti-p53 antibodies.