The Autotransplantation of Endometrial Tissue in the Rabbit

Abstract

It has been observed by Sampson1 that in women between the age of 30 and the menopause a frequent pathologic condition is found which consists in part of the presence of "chocolate" cysts of the ovary.These cysts are lined with ciliated epithelium, are surrounded by stroma like that of the endometrium, and take part in the menstrual cycle in much the same manner as does the uterine mucosa. When a cyst is close to the surface of the ovary, it may, and frequently does, rupture during menstruation, scattering, in the pelvic cavity, epithelial cells of the type lining the cyst and also menstrual blood. The menstrual blood possibly contains a substance which is capable of so altering the peritoneum that the epithelial cells from the cyst may become implanted where the peritoneum is injured, and develop, producing adenoma-like growths; or these cells may invade, from the outside, such structures as the oviduct, uterus, appendix and intestine, and cause a proliferative smooth muscle reaction, thus simulating very closely the so-called adenomyoma. This observation is of extreme interest, and, if correct, should, it seems, be susceptible of experimental demonstration, at least in some of its phases. With the purpose of investigating the matter from this standpoint, five rabbits were subjected to the following operative procedures. The animals were adult females, Belgian hares and Angoras, age unknown, but probably from 8 to 12 months old. All operations were performed under ether anesthesia and with aseptic precautions. REPORT OF EXPERIMENTSExperiment 1.-Four cm. of the right cornu was removed from Rabbit 1, about 5 cm. from the fimbriated end. The cut ends of the cornu were tied with silk, as were the vessels of the broad ligament of the part removed. The excised portion was opened longitudinally and the mucosa thoroughly scraped with a knife. The scrapings were gently rubbed into pre¬ viously scarified areas of the peritoneum of loops of the small intestine lying in the pelvis. Then this piece of the cornu was cut into very fine pieces, most of them less than 1 mm. in size, and about a dozen of these pieces were dis-From the department of pathology, Albany Medical College, and the pathologic laboratory of Albany Hospital.Read before the American Association of Pathologists and Bacteriologists,

An experimental model for the endometriosis in athymic mice

“…Autologous transplantation of endometrial tissue into the peritoneal sites has been attempted in rabbits, rhesus monkeys as an in vivo model of endometriosis (3)(4)(5)(6). Although these experimental systems are useful in examining the consequence of ectopic endometrium on fertility and related problems, their utility in the study of the pathogenesis of endometriosis is quite limited.…”

“…Attempts to develop animal models for this disease have primarily focused on surgical transplantation of endometrial tissue to peritoneal cavity in various animals (3)(4)(5)(6). Trauma, inflammatory responses and adhesions -processes which may have a significant role in the pathogenesis of endometriosis -are induced by surgery and hence confound the investigations using these models.…”

Aberrant Endometrial Tissue and Intussusception

“…metrium thrown off at menstruation is already degenerated or dead, so that it is not easy to conceive of it taking root in the peritoneum. (4) Experiments such as those of Jacobsen (1922), showing that endometrium can grow in the peritoneum, have dealt with the normal healthy endometrium of animals. (5) Experiments such as those of Heim (1929), in monkeys, in which a utero-abdominal fistula was created, have failed to show any development of endometrium, in spite of the fact that the menstrual blood was emptied freely into the abdomen.…”

Update on the diagnosis and treatment of bladder endometriosis

“…3. The migratory or metastatic theory of implantation through retrograde menstruation was proposed by Cullen [6,14,21] in 1897, advanced by Sampson [23], and experimentally shown in 1922 by Jacobson [24], who induced endometriosis in animals after implantation of endometrial tissue in the peritoneal cavity and bladder [6,21,23,24]. Retrograde menstruation of the endometrial tissue [23,25] through the fallopian tubes could reach any part of the female reproductive tract, as well as the bladder wall, and implant at these sites.…”