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Endometriosis in para-aortic lymph nodes during pregnancy: case report and review of literature
Anna L. Beavis, B.A., Koji Matsuo, M.D., Brendan H. Grubbs, M.D., Sucheta A. Srivastava, M.D., Christina M. Truong, M.D., Melissa N. Moffitt, M.D., Ana M. Maliglig, M.D., Yvonne G. Lin, M.D., M.S. Fertility and Sterility Volume 95, Issue 7, Pages 2429.e e13 (June 2011) DOI: /j.fertnstert Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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Figure 1 Pelvic computerized tomography (CT) and magnetic resonance imaging (MRI) of mass and lymphadenopathy. Axial nonenhanced CT of the pelvis demonstrates (A) a 2.5-cm left obturator lymph node (arrow) and (B) a homogenous mass encasing and inseparable from the lower uterine segment (arrow). Contrast-enhanced CT demonstrates low density centers in both the (C) obturator and (D) para-aortic lymph nodes. Note the homogenous enhancement of the mass enmeshed with the left ovary (C). (E) T1-enchanced MRI demonstrates iso- to slightly hyperintense mass surrounding lower uterine segment (arrowheads) and the left obturator lymph node (arrow). (F) Sagittal T2-enhanced fast spin echo through the mass surrounding the lower uterine segment demonstrates low internal T2 signal (arrowheads). Note the position of the inferior placenta covering the internal os (arrow). MR images were acquired with a GE 1.5T system: T1 FSPGR (TR/TE/FA 210/1.6/80); T2 SSFSE (TR/TE 1004/121). Fertility and Sterility , 2429.e e13DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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Figure 2 Histologic appearance of endometriotic implant in para-aortic lymph nodes. Low (×4) and high (×20) magnification of para-aortic lymph node with components of endometriosis: endometriotic glands (asterisk), hemosiderin-laden macrophages (solid arrowhead), multinucleated giant cells (arrow), lymphoid tissue (plus sign), and follicular germinal center (open arrowhead). H&E = hematoxylin and eosin. Fertility and Sterility , 2429.e e13DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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