Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.

The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphologic...

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Autores principales:	Okechukwu Charles Okafor, Ndubueze Ezemba, Nnaemeka Thaddeus Onyishi, Kevin Nwabueze Ezike
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f7181d8a8472415bbca40e732229a392
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spelling	oai:doaj.org-article:f7181d8a8472415bbca40e732229a3922021-12-02T20:05:34ZImproving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.1932-620310.1371/journal.pone.0251385https://doaj.org/article/f7181d8a8472415bbca40e732229a3922021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251385https://doaj.org/toc/1932-6203The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P<0.05). In this group, the strength of association is high for the first 4 features (Cramér's V≥0.5). The presence of ceroid macrophages is shown to be a novel key feature, previously unrecognised as such, for the identification of TE. The presence of any three of four features including endometrioid glands, lymphoid clusters, ceroid macrophages and siderophages is a suggested criterion for the definitive diagnosis of TE.Okechukwu Charles OkaforNdubueze EzembaNnaemeka Thaddeus OnyishiKevin Nwabueze EzikePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251385 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Okechukwu Charles Okafor Ndubueze Ezemba Nnaemeka Thaddeus Onyishi Kevin Nwabueze Ezike Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.
description	The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P<0.05). In this group, the strength of association is high for the first 4 features (Cramér's V≥0.5). The presence of ceroid macrophages is shown to be a novel key feature, previously unrecognised as such, for the identification of TE. The presence of any three of four features including endometrioid glands, lymphoid clusters, ceroid macrophages and siderophages is a suggested criterion for the definitive diagnosis of TE.
format	article
author	Okechukwu Charles Okafor Ndubueze Ezemba Nnaemeka Thaddeus Onyishi Kevin Nwabueze Ezike
author_facet	Okechukwu Charles Okafor Ndubueze Ezemba Nnaemeka Thaddeus Onyishi Kevin Nwabueze Ezike
author_sort	Okechukwu Charles Okafor
title	Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.
title_short	Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.
title_full	Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.
title_fullStr	Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.
title_full_unstemmed	Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.
title_sort	improving the diagnostic recognition of thoracic endometriosis: spotlight on a new histo-morphological indicator.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f7181d8a8472415bbca40e732229a392
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Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.

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