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Dan C. Martin, MD
UT Medical Group, Inc.

University of Tennessee Health Science Center (UTHSC)

UTHSC Academic Office

Daniel Clyde Martin, M.D.
UT Medical Group, Inc.
Infertility and Gynecology
Reproductive Surgery
Germantown Office Building
7945 Wolf River Boulevard
Suite 320
Germantown, Tennessee
TN 38138-1733

(901) 347-8331
(901) 347-8188 fax
Directions to Office

Updated information is at
UTMG 2006

Click for information on:
Glenn Ann Martin, Ph.D.
Clinical Psychologist

Leiomyomatosis Peritonealis Disseminata

Adapted from "Recognition of Endometriosis" in
Laparoscopic Appearance of Endometriosis, Lecture Supplement
Martin DC (ed), Resurge Press, Memphis, (c)1991

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Decidualization of foci of endometriosis may result in death of the cells and replacement with muscle metaplasia. This is associated with a variety of unusual histologies. Of these, the most dramatic is leiomyomatosis peritonealis disseminata. In this, the appearance is one of disseminated smooth muscle nodules throughout the pelvis. (Fujii, Okamura, Nakashima, Bann, Aso, & Nishimura, 1980; Parmley, Woodruff, Winn, Johnson, & Douglas, 1975; Woodruff & Parmley, 1988a; Woodruff & Parmley, 1988b)  This appearance is similar to fibroids.

Infiltrating, fibrotic lesions have a similar appearance and contain both fibrous and muscular components. (Cullen, 1896; Stripling, Martin, Chatman, Vander Zwaag, & Poston, 1988) This may represent a local tissue reaction to an infiltrating process or the end appearance of decidualization, death and metaplasia of the stroma of endometriosis. The collagen of infiltrating lesions is suggestive of a metaplastic process. This is contrasted to the collagen of ovarian endometriomas which appear to represent metastasis. (Khare, Martin, & Eltorky, 1996)

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Bibliography

bulletCullen, T. S. (1896). Adeno-myoma uteri diffusum benignum. Johns Hopkins Hosp Rep, 6, 133-157.
bulletFujii, S., Okamura, H., Nakashima, N., Bann, C., Aso, T., & Nishimura, T. (1980). Leiomyomatosis peritnealis disseminata. Obstet Gynecol, 55, 79-83.
bulletKhare, V. K., Martin, D. C., & Eltorky, M. (1996). A comparative study of ovarian and pelvic wall-infiltrating endometriosis. J Am Assoc Gynecol Laparoscopists, 3, 235-239.
bulletParmley, T. H., Woodruff, J. D., Winn, K., Johnson, J. W. C., & Douglas, P. H. (1975). Histogenesis of leiomyomatosis peritonealis disseminata (disseminating fibrosing deciduosis. Obstet Gynecol, 46, 511-16.
bulletStripling, M. C., Martin, D. C., Chatman, D. L., Vander Zwaag, R., & Poston, W. M. (1988). Subtle appearance of pelvic endometriosis. Fertil Steril, 49, 427-431.
bulletWoodruff, J. D., & Parmley, T. H. (1988a). Atlas of Gynecologic Pathology. New York: Gower Medical Publishing. 
bulletWoodruff, J. D., & Parmley, T. H. (1988b). The Endometrium. In J. D. Woodruff & T. H. Parmley (Eds.), Atlas of Gynecologic Pathology (pp. 4.3-4.32). Philadelphia: JB Lippincott.

Adapted from "Recognition of Endometriosis" in
Laparoscopic Appearance of Endometriosis, Lecture Supplement
Martin DC (ed), Resurge Press, Memphis, (c)1991

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