Morphological variations of scar-related and spontaneous endometriosis of the skin and superficial soft tissue: a study of 71 cases with emphasis on atypical features and types of müllerian differentiations

Dmitry V. Kazakov, Ondrej Ondic, Ondřej Ondič, Zamecnik M, Michal Zamecnik, Michal Zámečník, Ksenya V. Shelekhova, Ksenia V Shelekhova, Petr Mukensnabl, Mukensnabl P, Petr Mukenšnábl, Ondřej Hes, Ondrej Hes, Hes O, Dvorak V, Vladimír Dvořák, Vladimir Dvorak, Michal M, Michal Michal
Journal of the American Academy of Dermatology · 2007 · vol. 57(1) , pp. 134–146 · doi:10.1016/j.jaad.2006.11.036 · PMID:17572279 · W2166070398
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This study analyzed morphological variations in 71 cases of scar-related and spontaneous endometriosis, focusing on atypical features and Müllerian differentiation types.

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Abstract

BACKGROUND: Seventy-one cases of scar-related and spontaneous endometriosis of the skin and superficial soft tissue were studied, with a focus on atypical features and types of müllerian differentiation. All patients were women, whose ages ranged from 22 to 65 years (median, 32 years). METHODS: Histological, immunohistochemical, and electronmicroscopic studies were performed. Clinical information was ascertained via a questionnaire solicited by the referring physicians. RESULTS: All types of metaplastic changes of müllerian epithelium were found, including tubal (61%), oxyphilic (15%), hobnail (10%), mucinous (4%), and papillary syncytial (3%) metaplasia. Atypical features included reactive atypia (23%) and atypical mitoses in glandular epithelium (6%). Stromal changes included smooth muscle metaplasia (31%), decidualization (<1%), stromal endometriosis (<1%), and elastosis (<1%). Other features recognized included lipoblast-like cells (15%), some with intranuclear inclusions; atypical/degenerative myocytes (10%); spiral arteries (4%); and perineurial invasion (<1%). CD56 staining identified large granular lymphocytes in 15 of 20 studied specimens. Ultrastructurally, these cells showed cytoplasmic granules, some with a delimiting membrane. LIMITATIONS: This study utilizes tissue specimens that mainly were received as consultations; therefore some inherent selection bias exists. Specimens were randomly selected for CD56 immunostaining, leading also to potential sampling error. CONCLUSIONS: All types of müllerian metaplasia can be encountered in cutaneous endometriosis. In addition, so-called atypical features described in endometriosis affecting other anatomic sites may be seen in the skin. Some features may represent a diagnostic pitfall.

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Condition tags

endometriosis

MeSH descriptors

Cicatrix Endometriosis Skin Diseases Adult Adult Aged Aged CD56 Antigen CD56 Antigen CD56 Antigen Cicatrix Cicatrix Endometriosis Endometriosis Epithelium Epithelium Epithelium Female Female Humans

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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