PECULARITIES OF RELATIONSHIPS BETWEEN THE CELLULAR MICROENVIRONMENT OF ENDOMETRIOID CYSTS AND THEIR CHANGES IN THE COURSE OF CYST EVOLUTION
Objective. To assess the location, type, and strength of correlations between cells in endometrioid cysts walls at various stages of their formation. Methods. The study included 57 patients with a histologically verified diagnosis of endometrioid ovarian cyst. Previously, based on a number of morphological features, all the endometrioid cysts were divided into "young", "mature" and "old". The number of lymphocytes, neutrophils, eosinophils, and macrophages in 10 fields of view was counted in the cyst wall after staining with hematoxylin and eosin at X400 magnification. Results. In the tissues of a "young" endometrioid cyst, macrophages of the stroma of the endometrioid lining have positive correlations with macrophages of other zones. The structure of correlation connections of lymphocytes is absolutely identical with macrophages. Correlations in the tissues of a "mature" endometrioid cyst between macrophages in different zones retain their number, location, and nature, but their strength changes. Correlations between lymphocytes no longer go side by side with macrophages, but still retain some similarities. Macrophages in all the studied areas of the "old" endometrioid cyst no longer form correlations with each other. The only correlation between uterine epithelial lymphocytes and endometrioid lining stroma lymphocytes remains, changing the direction from negative to positive. Positive correlations are observed between granulocytes in the studied areas, regardless of the type of endometrioid cyst. Conclusions. Macrophages are the cell center that regulates the homeostasis of endometrioid heterotopia, whose polarization during the evolution of the endometrioid cyst, aimed at eliminating the consequences of circulatory disorders, leads to depletion of the pool of endometrium-associated macrophages. Lymphocytes act as macrophages of the cell subordinate to the structure. Granulocyte infiltration as a manifestation of a classical acute inflammatory reaction from the theca stroma of the ovary during aging cysts overcomes the barrier in the form of a fibrous layer on the border of the theca and stroma of endometrioid heterotopy that causes the macrophages to activate fibrosis, causing compaction, which leads to disruption of blood supply to the tissue of endometrioid heterotopias, followed by gradual atrophy of the endometrial lining until its complete disappearance.