Abstract
In a powerful opening statement, Sampson compared the prevalence at operation of “the pathologic conditions arising from the implantations of epithelium which escape from the fallopian tubes into the peritoneal cavity” as second in prevalence only to leiomyomas of the uterus in women between the age of 30 years and menopause.1 Here in the short span of only 2 years after Cullen’s last major publication, Sampson spoke of pelvic adenomas and ovarian hematomas of endometrial type as a common disease entity of women in their fourth and fifth decades. He clarified new terminology used in the title of this paper. “I have discarded the term ‘perforating hemorrhagic cysts’ as applied to this condition, because perforations may occur in other varieties of ovarian hematomas. I now refer to them as hematomas or hemorrhagic cysts of endometrial (müllerian) type.”2
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- 1.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:451.
- 2.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:452:454.
- 3.
Note how unsettled and awkward the terminology at this juncture: glands or tubules (adenomas) of endometrial (müllerian) type.
- 4.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:451–452. Sampson raised the perennial question, how does the surgeon distinguish, which lesions are more likely to become invasive?
- 5.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:452.
- 6.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:452.
- 7.
Meigs, JV. Endometrial hematomas of the ovary. Boston Med Surg J 1922:187:1–13.
- 8.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:474. See description accompanying Fig. 29. - Plate III (Case 5) on the bottom of page 474. See also the text on page 478, which reads: When “perforation [of the ovarian cyst] occurs and some of the contents of the cyst escapes into the peritoneal cavity carrying with it epithelial cells which apparently give rise to implantation adenomas wherever the epithelium falls on suitable ‘soil.’”
- 9.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:454. “I have discarded the term “perforating hemorrhagic cysts” as applied to this condition, because the perforations may occur in other varieties of ovarian hematomas. I now refer to them as hematomas or hemorrhagic cysts of endometrial (müllerian) type. Their epithelial lining, where present, is similar to that found in the hematomas due to the retention of “menstrual” blood, which occur in the adenomyomas of the uterus derived from the uterine mucosa, and the blood in the ovarian hematomas is also apparently of menstrual origin.”
- 10.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:457.
- 11.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:457–458.
- 12.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:461.
- 13.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:462. Ibid: 468, Fig. 16. (Case 16). “Photomicrographs…of the adenomas of endometrial (müllerian) type invading the lateral surface of the right ovary and posterior surface of the uterus…Their histological structure is similar, and I believe that they both have a common origin from epithelium escaping from or through the fallopian tube. It is impossible to decide, from their structure, whether the epithelium was derived from the tubal or the uterine mucosa.”
- 14.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:462.
- 15.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:463.
- 16.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:463.
- 17.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:462.
- 18.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:465.
- 19.
Jacobson VC. The autotransplantation of endometrial tissue in the rabbit. Archives Surgery 1922;5:281–300.
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Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:465–466.
- 21.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:453. Quotation from the legend under Figure 1.
- 22.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:453. Quotation from the legend under Figure 1.
- 23.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:455. See also Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary). Archives of Surgery 1922;5:217–280.
- 24.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:456.
- 25.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:463.
- 26.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:466.
- 27.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:467.
- 28.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:468.
- 29.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:469.
- 30.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:469.
- 31.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:469–70.
- 32.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:469.
- 33.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:469.
- 34.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:485. By early stage, Sampson meant an early stage of ovarian hematomas of endometrial type, ovarian hematomas that had not perforated. Specifically Sampson stated: “The cases reported in the present [third] series were chosen from those demonstrating the origin and development of ovarian hematomas of endometrial type and ovarian hematomas without perforation rather than from those with perforation and extensive implantations.”
- 35.
Sampson JA. Control of hemorrhage following pelvic operations by packing the pelvis with gauze through a proctoscope and maintaining counter pressure by packing the vagina. Johns Hopkins Hosp Bull 1903;14:237–42.
- 36.
Fitzgerald WJ. John Albertson Sampson, MD: pioneer gynecologist, teacher, and researcher. NY State J Med 1966;66:1244–7: 1246. Dr. Fitzgerald was a clinical instructor in the Department of Obstetrics and Gynecology, The Albany Medical College of Union University at the time of Sampson’s death.
- 37.
Kelly HA. An improved attachment for the head-mirror. Med News Philadelphia 1883:xliii:390.
- 38.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:473.
- 39.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:472.
- 40.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:473.
- 41.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:478. Sampson believed “the escape of the contents of the cyst probably prolongs its life. It relieves tension and thus favors repair until the next reaction to menstruation.” See page 510. “The hematomas developing in the deeper tissues of the ovary may attain a large size, several centimeters in diameter, before perforation occurs. As the menstrual blood is retained in the cavity of the hemorrhagic cyst and in the stroma of the lining for a long time, many interesting histologic changes occur in the wall of the cyst in the attempt to absorb the menstrual blood, and to reline the denuded surface by epithelium from that which had not been removed by menstruation. The development and activities of the endothelial leucocytes, which act as scavengers, play an important part in the absorption of the menstrual blood and the deposit of the pigment, derived from this blood, in the walls of the hematoma. Perforation permits the contents of the hematomas to escape into the peritoneal cavity, and may temporarily relieve the embarrassment caused by its retention. The perforation is sealed by the ovary or cyst becoming adherent to adjacent structures at the site of its perforation. The hematoma again fills up with blood at its next reaction to menstruation, and repeated perforations may occur. As the reaction to menstruation is destructive, and as the repair and regeneration of the epithelial lining is accomplished under great difficulties (due to the retention of the menstrual blood), the ultimate tendency of the hemorrhagic cyst is one of retrogression.”
- 42.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:473. Sampson described the mechanism in detail on page 473–474.
- 43.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:475.
- 44.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:504. See Fig. 66.-(Case 14) on page 504 entitled: Sagittal section of the uterus shown in the preceding illustration, demonstrating the early pregnancy (embryo 14 mm long) (x 3/5). You might ask, how could Sampson miss diagnosing this early pregnancy and avoid the hysterectomy? After all he describes the 37 year old woman as sterile and having wanted children. The answer is two-fold. First this was before pregnancy tests were available, moreover her periods or uterine bleeding was regular. Secondly, from examination of the illustration, there was a large intramural fibroid anteriorly, a smaller subserous fibroid protruding as a knob from the top of the uterus, and a large fibroid protruding from the posterior uterus. From my own clinical experience, the strategic position of the fibroids, which by their name reveals their fibrous nature, precludes any appreciation of softening of the underlying uterus associated with pregnancy.
- 45.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:481-482.
- 46.
J. Whitridge Williams. Decidual formation through the uterine muscularis: a contribution to the origin of adenomyoma of the uterus. Transactions of the Southern Surgical Association 1904;17:119.
- 47.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:472.
- 48.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:583.
- 49.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:483.
- 50.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:483.
- 51.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:483.
- 52.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:483.
- 53.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:483.
- 54.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:483–484.
- 55.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:485.
- 56.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323.
- 57.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary). Archives of Surgery 1922;5:217–280.
- 58.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:485.
- 59.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:495–496.
- 60.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:488, 489, 493, 500, 503, 505.
- 61.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:509. See pages 497–498. Case 12: 41-year-old woman with “bilateral hematosalpinx and ‘adenomyoma’ of the distal ends of both tubes with extension through to their peritoneal surface, implantation adenoma of endometrial type on the posterior surface of the uterus, small intramural leiomyomas of the uterus (no evidence found of hematomas of endometrial type in the ovaries).” Sampson believed “that the adenoma on the posterior surface of the uterus arose from this source…miniature endometrial hematomas” in the distal end of both fallopian tubes.
See pages 501–502. Case 15: 36-year-old woman with implantation adenoma of endometrial type on the mesial surface of the right ovary and on the anterior surface of the uterus just below the attachment of the right round ligament. Sampson believed “that the implantations on the ovary and on the anterior surface of the uterus probably arose from epithelium escaping from the tube.”
See page 506–507. Case 18: 22-year-old woman with implantation adenoma (of endometrial type) of the posterior uterine wall, culdesac, and posterior surface of the right broad ligament; retroflexion of the uterus. Sampson noted: “the uterus was found to be retroflexed and after replacing it a pigmented (hemorrhagic) elevation about 2 mm. in diameter was noticed on the posterior surface of the right uterine cornu, and a similar but broader elevation (implantation) was detected in the culdesac, at place which exactly came in contact with the implantation on the uterus when the latter was replaced in retroflexion. A similar implantation (but not hemorrhagic) was found on the posterior surface of the right broad ligament. Both tubes and ovaries appeared normal, and the latter were examined very carefully for implantation…These implantations were in situations which at times could have been in contact with the fimbriated end of the right fallopian tube, and I believe arose from epithelium escaping from the tube. The implantation on the surface of the uterus might have been a contact implantation from the one in the culdesac, or vise versa.”
See page 507–509. Case 19: 32-year-old woman with implantation adenoma (of endometrial type) of the mesial surface of the right ovary, the right broad ligament between the tube and the ovary and on the suspensory ligament of the ovary; retroflexion of the uterus. “The situation of the implantation, especially the one directly in front of the fimbriated end of the tube, on the suspensory ligament of the ovary, would indicate that they arose from epithelium escaping from or through the fimbriated end of the tube.”
- 62.
Sampson, JA. The life history of ovarian hematomas (hemorrhagic cysts) of endometrial (müllerian) type. American Journal of Obstetrics and Gynecology 1922;4:451–512:511.
- 63.
Sampson, JA. American Journal of Obstetrics and Gynecology 1922;4:451–512:512.
- 64.
Cullen TS. In Memoriam: John Albertson Sampson: 1873–1946. Trans Am Gynecol Society 1947:70:273–4.
- 65.
Cullen TS. In Memoriam. Trans Am Gynecol Society 1947:70:273–4. “Especially to Dr. Howard Kelly was Dr. Sampson indebted for the stimulating example of a great surgeon and God-loving man.”
- 66.
Cullen TS. In Memoriam Trans Am Gynecol Society 1947:70:273–4. In 1890, at the age 17, Sampson “wrote a report on the evening grosbeak for Forest and Stream.”
- 67.
Sampson JA. President’s Address. Fundamental elements in the advancement of medicine. Am J Obstet Gynecol 1923;6:1–11:2–3.
- 68.
Sampson JA. President’s Address. Am J Obstet Gynecol 1923;6:1–11:4, Kelly had a lifelong interest in botany and from this interest wrote a book entitled “Some American Medical Botanists.” Kelly was also interested in poisonous snakes. Kelly HA. Poisonous snakes. Johns Hopkins Hosp Bull 1900;xi:73.
- 69.
Sampson JA. President’s Address. Am J Obstet Gynecol 1923;6:1–11:5.
- 70.
Sampson JA. President’s Address. Am J Obstet Gynecol 1923;6:1–11:4.
- 71.
Sampson JA. President’s Address. Am J Obstet Gynecol 1923;6:1–11:8–9.
- 72.
Sampson JA. President’s Address. Am J Obstet Gynecol 1923;6:1–11:11.
- 73.
Sampson JA. President’s Address. Am J Obstet Gynecol 1923;6:1–11:9.
- 74.
T.K.A.B. Eskes and L.D. Longo, eds. Classics in Obstetrics and Gynecology: Innovative Papers that Have Contributed to Current Clinical Practice [Pearl River, NY: Parthenon Publishing Group, 1994], 277–236.
- 75.
Knud Faber, Nosography in Modern Internal Medicine [New York: Paul B. Hoeber, Inc., 1923], 57.
- 76.
T.K.A.B. Eskes and L.D. Longo, eds. Classics in Obstetrics and Gynecology: Innovative Papers that Have Contributed to Current Clinical Practice [Pearl River, NY: Parthenon Publishing Group, 1994], 277–236. The editors reprinted Sampson’s paper. Editorial comments followed on pp. 327–337.
- 77.
Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol 1927;l4:422–469.
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Batt, R.E. (2011). Life History of Ovarian Endometriomas. In: A History of Endometriosis. Springer, London. https://doi.org/10.1007/978-0-85729-585-9_9
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