PMC3516977_01
Right (A) and left (B) diaphragmatic peritoneum widely involved by confluent nodules, from 0.5 cm to 5 cm, infiltrating the diaphragmatic central tendon, close to the upper hepatic veins and on the diaphragmatic pericardial insertion. Right (C) and left (D) wide diaphragmatic resection, with opening of the pleural and pericardial cavity, revealing multiple parietal full-thickness infiltrating nodules involving the parietal pleura, the diaphragmatic central tendon and infiltrating the diaphragmatic side of the pericardium. Right pleural and diaphragmatic suture (E) and left pleural and diaphragmatic suture with pericardial window closure (F) by a single layer (1-0 polypropylene) suture
WIITM-7-18092-g001.jpg
PMC3516977_01_WIITM-7-18092-g001.jpg
F0001
A - Gross section of the diaphragm. The normal architecture is destroyed by the presence of numerous endometriotic cysts. B - Histology of the parietal pericardium. The fibrous tissue is infiltrated by typical endometriosis. C - At high power a focus of endometriosis showing part of an endometriotic gland and a cuff of periglandular endometriotic stroma containing dilatated blood vessel. At the periphery myocytes are visible (arrow). D - The periglandular endometriotic stroma shows immunoreactivity for CD10
WIITM-7-18092-g002.jpg
PMC3516977_01_WIITM-7-18092-g002.jpg
F0002
The musculature of the diaphragm was replaced by several cysts filled with chocolate-like material (Figure 2).