Sampson, J. A. (1927). Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. The American journal of pathology, 3(2), 93-110.43.
Sampson JA. Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. Am J Pathol. 1927;3(2):93-110.43.
Sampson, J. A. "Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation." The American journal of pathology, vol. 3, no. 2, 1927, pp. 93-110.43.
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Endometriosis Can Spread Through Veins, a 1927 Study Showed
In 1927, Dr. John Sampson studied uterus tissue taken out during surgery from women on their period. Among uteri removed during a period, he found bits of uterine lining inside veins in 3 of them, but in only 1 of many uteri removed at other times. This tissue can enter veins and grow there, he concluded.
Key Findings
Bits of uterine lining showed up in veins in 3 uteri removed during a period. In 2 others, he found cell clumps he could not identify. In 3 more, he found none.
Among many uteri removed at times other than a period, this kind of tissue was found in a vein in only 1 case.
In one case, several small growths of uterine-lining tissue were attached to vein walls. They were not connected to any lining tissue outside the vessel.
In a separate lesion on the back vaginal wall, Sampson directly saw period blood leaking from two misplaced pockets of uterine lining into nearby veins.
Sampson concluded that bits of uterine lining shed during a period are sometimes still alive. They can attach to the inside of nearby veins.
Interpretation
This is a 1927 case study. The paper predates modern clinical trial methods. Sampson injected uterine veins with a tracing material, then studied thin tissue slices from removed uteri under a microscope for bits of uterine lining inside the veins. A study like this can show that the tissue was present inside veins in these specimens. The design cannot show how often this happens in women in general. The study also cannot prove this vein route explains most cases of endometriosis found elsewhere in the body. Sampson called several of his own conclusions unproven. He noted some findings in uteri removed during a period could be slide-preparation artifacts.
RRM Context
In this same paper, Sampson lists several possible origins for endometriosis. These include direct tissue growth into the uterine wall, implants from period blood flowing backward through the tubes, and this vein route. Almost a century later, no single idea fully explains where this tissue ends up. Restorative reproductive medicine treats endometriosis as a disease to cut out surgically wherever it is found. The approach holds true no matter which route placed the tissue there. The strategy differs from simply suppressing the cycle that carries the tissue.
Our editorial summary of this paper, not the article's abstract.
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