Cytomorphological spectrum in scar endometriosis: a study of eight cases

S K Pathan, Pathan SK, Shahed K. Pathan, K Kapila, Kusum Kapila, Kapila K, Haji BE, B E Haji, Bahiyah E. Haji, Mrinmay K. Mallik, M K Mallik, Mallik MK, Taiba A. Alansary, T A Al-Ansary, Al-Ansary TA, S. S. George, George SS, Dilip K. Das, Das DK, D K Das, Francis IM, Issam M. Francis, I M Francis
Cytopathology : official journal of the British Society for Clinical Cytology · 2005 · vol. 16(2) , pp. 94–99 · doi:10.1111/j.1365-2303.2004.00218.x · PMID:15787652 · W2015648707
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This study analyzed the cytomorphological features of eight abdominal wall endometriosis cases diagnosed by fine needle aspiration cytology, finding epithelial clusters, stromal cells, and haemosiderin-laden macrophages.

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Abstract

OBJECTIVE: Endometriosis due to ectopic endometrial tissue that responds to hormonal stimulation and is extremely rare in a surgical scar appearing in 0.1% of women who have undergone Caesarean section. Fine needle aspiration cytology (FNAC) can be a valuable diagnostic aid in the evaluation of these subcutaneous abdominal masses. METHODS: We present the cytomorphological spectrum in eight cases of abdominal wall endometriosis diagnosed by FNAC over a 6-year period (June 1998-June 2004) in Mubarak Al-Kabeer Hospital (Kuwait). The patients ranged from 27 to 56 years of age. Seven had a prior Caesarean section and one had a hysterectomy for fibroid. They presented 3-8 years later with nodules in/near the abdominal scar. Five cases presented with a painful nodule, fluctuant with the menstrual cycle. RESULTS: Cytological findings comprised epithelial clusters and fusiform stromal cells with numerous haemosiderin-laden macrophages. Mild to moderate epithelial atypia was observed in three cases. A diagnosis of endometriosis was rendered in all the eight cases and tissue was available in four cases. CONCLUSIONS: Endometriotic nodules need to be differentiated from other benign/malignant masses and evaluated for possible malignant transformation. FNAC provides a safe and effective tool for diagnosis thereby obviating the need for other procedures.

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Condition tags

endometriosis

MeSH descriptors

Cesarean Section Cicatrix Endometriosis Abdomen Adult Biopsy, Fine-Needle Cicatrix Endometriosis Endometriosis Endometriosis Female Humans Macrophages Macrophages Middle Aged Stromal Cells Stromal Cells

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