Purpose: to evaluate the correlation between the laparoscopic aspects and the stromal histologic findings of peritoneal endometriosis in order to understand the evolutive theory of endometriosis. Methods: sixty-seven women were submitted to laparoscopy for pelvic pain, infertility, ovarian tumor and other pathologies. A peritoneal biopsy was taken from the typical (puckered black) and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (Group V), black lesions (Group N) and white lesions (Group B). The histological sections were examined according to a standardized protocol. The histologic parameters used were: depth of the lesion, presence of hemosiderin, vascularization of the stroma and fibrotic tissue in stroma. Results: regarding lesion depth, there were significant differences between the groups. Red lesions were located consistently on the surface of the peritoneum (100%) and black lesions were superficial in 55.6%, intermediate in 38.9% and deep in 5.5%. White lesions were superficial in 28%, intermediate in 68% and deep in 4%. The presence of hemosiderin showed equivalent results in the 3 groups. The large stromal vascularization was present in the red lesions (60%), which a statistically significant difference compared to the other groups. Fibrotic tissue was present in 70.6% of the white lesions (group B), a fact that was significantly different when compared to groups V and N. Conclusion: the parameters analyzed in this study confirmed the importance of the evolutive theory of endometriosis.
Endometriosis; Laparoscopy; Pelvic pain; Hemosiderin
