P19.01: Histologic correlate of (sub)endometrial echogenic foci: report of two cases

Although (sub)echogenic foci are common, especially after term pregnancy (T.Van den Bosch et al., Ultrasound Obstet Gynecol 2003; 22 (suppl 1):146–7), their histological correlate is not well established. Some authors hypothesized that small air bubbles due to instrumentation or infection could be responsible. We present the histology findings of the hysterectomy specimen in two patients with echogenic foci. The first patient was 45 year old P5G5 and underwent a total abdominal hysterectomy for menorrhagia whereas the second case was a 43 years old P1G1 and underwent a vaginal hysterectomy for recurrent cervical dysplasia after conization. At preoperative ultrasound several (sub)endometrial echogenic foci were visualized in both patients. The presence of echogenic foci was confirmed by ultrasound of the hysterectomy specimen. No lesion was found on macroscopic examination and after lamellation of the uterus. At microscopy there was a prominent calcification in a subendometrial lesion of adenomyosis in the first case, whereas in the second patient there was a small calcification in the basal layer of the cytogenic stroma. This case report suggests that, at least in some cases, (sub)endometrial echogenic foci do have a histological correlate.