Causes of Endometriosis: Coelomic Metaplasia Theory(2)
The germinal epithelium, pelvic peritoneum and pleura of the ovary all originate from the lymphatic and venous dissemination of the coelomic epithelium. They can be transformed into endometrioid tissue and form endometriosis by repeated stimulation of menstrual blood, hormone, or chronic inflammation.
Because the ovary and Mullerian tubes are both derived from the coelomic epithelium, the coelomic metaplasia theory can explain the endometriosis of ovary. Metaplasia can also explain the pathological changes in the distant parts such as chest, limbs, and umbilicus, and serous cells that can also be found.
This theory can even be extended to the peritoneum to explain peritoneal endometriosis. They believe that part of the peritoneum is a differentiated tissue, and can produce tissue similar to normal endometrium. Peritoneal mesothelium also has the ability of proliferation and differentiation.
However, no endometriosis was found in other tissues differentiated from coelomic epithelium except ovary, Mullerian tube, and peritoneum, which challenged the theory of coelomic metaplasia. So far, there are not enough clinical or experimental data for this theory.
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