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Cytomorphological spectrum in scar endometriosis: a study of eight cases
Author(s) -
Pathan S. K.,
Kapila K.,
Haji B. E.,
Mallik M. K.,
AlAnsary T. A.,
George S. S.,
Das D. K.,
Francis I. M.
Publication year - 2005
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/j.1365-2303.2004.00218.x
Subject(s) - medicine , endometriosis , nodule (geology) , atypia , caesarean section , radiology , surgery , pathology , pregnancy , paleontology , genetics , biology
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.