Kim Jung Yeon, Kwon Ji Eun, Kim Hyun-Jung, Park Kyeongmee
Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea.
Diagn Cytopathol. 2013 Feb;41(2):115-9. doi: 10.1002/dc.21779. Epub 2011 Oct 11.
While about 15% of menstruating women develop endometriosis, abdominal wall endometriosis is relatively rare. We present 10 cases of abdominal wall endometriosis diagnosed by fine-needle aspiration (FNA) cytology and confirmed by subsequent surgical excision. A palpable abdominal wall mass was the most common symptom, followed by pain. Nine cases were associated with previous surgery. The smear showed glandular epithelial cells and spindle or ovoid stromal cells accompanied by macrophages in eight cases. The nucleus was round-to-oval and the nucleolus was inconspicuous. Mitosis was not observed in any case. In two cases, which were suspicious of malignancy on FNA, the epithelial cells showed anisonucleosis, hyperchromasia, and small conspicuous nucleoli. The stromal cells were spindle or ovoid in shape, without metaplastic changes. Histiocytes were noted in nine cases and hemosiderin-laden histiocytes were noted in two cases. The proportion of inflammatory cells varied. FNA diagnosis of abdominal wall endometriosis is possible when the cytological features are interpreted cautiously, together with the patient's clinical history. An accurate diagnosis on FNA will prevent unnecessary surgery.
虽然约15%的月经女性会患上子宫内膜异位症，但腹壁子宫内膜异位症相对少见。我们报告10例经细针穿刺（FNA）细胞学诊断并经后续手术切除证实的腹壁子宫内膜异位症病例。可触及的腹壁肿块是最常见的症状，其次是疼痛。9例与既往手术有关。涂片显示8例有腺上皮细胞和梭形或卵圆形间质细胞，伴有巨噬细胞。细胞核呈圆形至椭圆形，核仁不明显。所有病例均未观察到有丝分裂。在2例FNA怀疑为恶性的病例中，上皮细胞显示核大小不一、核染色质增多和明显的小核仁。间质细胞呈梭形或卵圆形，无化生改变。9例可见组织细胞，2例可见含铁血黄素的组织细胞。炎症细胞的比例各不相同。当谨慎解读细胞学特征并结合患者临床病史时，FNA诊断腹壁子宫内膜异位症是可行的。FNA的准确诊断将避免不必要的手术。
