Endometriose: Diagnose ohne histologisches Korrelat – Möglichkeiten der Verbesserung

The study evaluated whether adding serial sectioning (stufenschnitte) to initial hematoxylin-eosin histology improves the histological detection rate of endometriosis lesions, particularly in relation to lesion morphology and the number of additional section levels examined. In 100 consecutive patients with endometriosis-typical symptoms, the authors prospectively examined 242 suspected lesions plus 68 control biopsies from paraffin-embedded tissue, by cutting three deeper additional levels when the first HE section was negative, and quantified the number of levels needed to identify endometrial glands and stroma. Histological confirmation increased significantly from 63.2% to 73.6% with serial sectioning (p<0.001), with the greatest diagnostic gain up to 15% for peritoneal lesions, and 98% of confirmed lesions detected across only 3 of 4 levels; however, the paper’s improvement was most notable for minimal to mild disease (7 of 9 additional cases). This paper is centrally about endometriosis—improving histologic diagnosis when lesions lack an initial histologic correlate.

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