Aziz Zared, Wang Don
Department of Pathology, St. Joseph's Health Care Centre, Toronto, Ontario, Canada.
Diagn Cytopathol. 2011 Jun;39(6):443-5. doi: 10.1002/dc.21458. Epub 2010 Aug 20.
Endometriosis is a relatively common disease in women, usually of reproductive age. In rare occasions, endometriosis may occur in unusual body sites, including extragonadal, extra-pelvic sites, or in the skin. We report a case of endometriosis of the abdominal wall diagnosed by fine-needle aspiration biopsy (FNAB). The patient was a 41-year-old woman with a clinical impression of "desmoid" tumor of the abdominal wall. FNAB showed groups of epithelial cells with mild nuclear atypia and rare mitoses. A few small clusters of slightly atypical spindle cells were also seen. The initial screening impression was adenocarcinoma due to the atypical cytological features. However, after review with the pathologist, the FNAB was signed out as "endometriosis." Subsequent local excisional biopsy confirmed the diagnosis of endometriosis. In conclusion, endometriosis may present diagnostic challenges in FNAB and this possibility should be considered in differential diagnosis. A clinical cytopathological correlation is necessary to avoid a misdiagnosed as an adenocarcinoma.
子宫内膜异位症是一种在女性中相对常见的疾病，通常发生于育龄期。在极少数情况下，子宫内膜异位症可能出现在不寻常的身体部位，包括性腺外、盆腔外部位或皮肤。我们报告一例通过细针穿刺活检（FNAB）诊断的腹壁子宫内膜异位症病例。患者为一名41岁女性，临床印象为腹壁“硬纤维瘤”。FNAB显示上皮细胞群，核轻度异型，有罕见的有丝分裂。还可见少数小簇轻度非典型梭形细胞。由于细胞学特征不典型，最初的筛查印象为腺癌。然而，经病理学家复查后，FNAB报告为“子宫内膜异位症”。随后的局部切除活检证实了子宫内膜异位症的诊断。总之，子宫内膜异位症在FNAB中可能带来诊断挑战，在鉴别诊断中应考虑到这种可能性。临床细胞病理学相关性对于避免误诊为腺癌是必要的。
