Spontaneous Abdominal Wall Endometriosis Diagnosed by Fine Needle Cytology: A Case Report

Punam Paudyal
In: Advances in Cytology & Pathology · 2017 · vol. 2(4) · doi:10.15406/acp.2017.02.00030 · W2779465662
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This case report details a spontaneous abdominal wall endometriosis diagnosis in a patient with cyclical suprapubic swelling, confirmed by ultrasound-guided fine needle aspiration cytology.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This case report describes a 35-year-old woman with suprapubic swelling (1×1 cm) and pain with cyclical enlargement during menstruation, but with no prior operative history and non-specific ultrasound findings including normal ovaries and bowel. Ultrasound-guided fine needle aspiration cytology from the swelling showed epithelial cells in monolayer sheets consistent with endometrial cytology, along with stromal fragments, hemosiderin-laden macrophages, lymphocytes, and necrotic debris, leading to a diagnosis of spontaneous abdominal wall endometriosis based on site and cytology. The paper explicitly notes that imaging is non-specific and that biopsy is necessary for definitive diagnosis, though it presents cytology as an accurate preoperative tool. This paper is centrally about endometriosis — spontaneous abdominal wall endometriosis diagnosed by fine needle cytology in a scarless suprapubic lesion.

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Abstract

Endometriosis is presence of tissue histologically similar to endometrium outside of the uterine cavity, most commonly consisting of both endometrial glands and stroma. Spontaneous abdominal wall endometriosis is any ectopic endometrium found superficial to the peritoneum without the presence of any previous scar. We report here a case presented with suprapubic swelling which was associated with cyclical symptoms as well. Ultrasound guided fine needle aspiration done from the swelling reveal cytologic features of endometriosis. Considering the site diagnosis of spontaneous abdominal wall endometriosis was made. The aim of this case report is to remind that some very rare site may be involved in endometriosis and cytology can provide accurate preoperative diagnosis of endometriosis.

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endometriosis

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