Lysosomal evaluation of endometrioma capsule epithelium and endometrium of patients with or without endometriosis.

OBJECTIVE: To evaluate the number of lysosomes in glandular epithelia of the endometrioma capsule and endometrium from patients with or without endometriosis using a histochemical method (acidic phosphate determination) under light microscopy. METHOD: We studied 31 selected patients with similar clinical features, except for the occurrence of menorrhagia enhanced in patients with endometriosis. All patients were submitted to video laparoscopic procedures and endometrial biopsies through hysteroscopy during the secretory phase. After surgery, the patients were divided into two groups for hysteroscopic data: GI--without endometriosis (control, n = 16) and GII--with endometriosis (n = 15). In GII, the lysosomes of the endometrioma were also counted (GIIa). RESULTS: The GI sample was comprised only of endometrial biopsies. We found that the number of lysosomes in the topic endometrial tissue of patients with endometriosis was significantly larger than the number in endometrioma. Also, there were more lysosomes in the endometrium of patients with endometriosis than in endometrioma-bearing patients. CONCLUSION: Our data suggest that variations in the number of lysosomes may underlie the pathogenesis of endometriosis.

Ultrasonographic and morphological studies of the postmenopausal endometrium using unopposed estrogen replacement therapy with regular pause: a prospective preliminary study.

UNLABELLED: Hormone replacement therapy with progestogen is known to have severe side effects or complications in certain patients. OBJECTIVE: The goal of this study is to evaluate the safety and efficacy of an alternative treatment regimen with a mensal pause using both transvaginal sonography (TVS) and endometrial biopsy to follow patients. METHODS: A total of 30 postmenopausal women were treated with unopposed estrogen for 21 days each month followed by a regular pause of 9-10 days, and were studied prospectively for 18 months. The TVS measurements of endometrial thickness and biopsy of the endometrium were done on the 21st day of treatment and the 7th day of the pause at 6-month intervals throughout the study. RESULTS: There was a significant decrease of proliferative activity at all three time points during the study (6, 12 and 18 months) when tested on the 7th pause day (PD7). The percentage of patients with hyperplasia without nuclear atypia and endometrial thickness > or =8mm was 32% at 6 months, but decreased to 22 and 19% at 12 and 18 months, respectively. All cases of hyperplasia regressed after the hormonal pause throughout the treatment period. CONCLUSIONS: This study presents an alternative treatment regimen for select patients having side effects or complications from progestogen administration; however, studies evaluating the safety and efficacy of this regimen over longer time periods are necessary.

Morphological action of tamoxifen in the endometrium of persistent estrous rats.

BACKGROUND: The aim of this study was to evaluate the action of tamoxifen on the endometrium in states of chronic anovulation. METHODS: Thirty-eight rats inducted to persistent estrous (testosterone propionate) confirmed by hormonal colpocytology were divided into a control and an experimental group; the latter received tamoxifen and had fragments of the uterine horns processed for morphological and morphometrical analysis. Data were analysed statistically by the Mann-Whitney and Student's t tests. RESULTS: Our findings revealed minor uterine weight, epithelial thickness; number of endometrial glands and low eosinophil counts in the group that received tamoxifen. These results were statistically significant. We often observed areas of metaplasic stratified squamous epithelium between cylindrical epithelial cells in both groups. CONCLUSIONS: Our results indicate that antiestrogenic effect of tamoxifen was only partial in persistent estrous, since there was no blocking against the squamous metaplasia of the endometrium.