Cytodiagnosis of scar endometriosis

Scar Endometriosis: Cytological Diagnosis

“…6 It is underreported as it is often clinically mistaken for incisional hernia, suture granuloma, abscess, lipoma and neoplastic conditions. 5 Etiology of endometriosis has been attributed to either, metaplasia where endometriosis arises spontaneously from metaplasia of pluripotential mesenchymal cell or the transport, suggesting that endometrial cells may be transported to scar site, during surgical procedures. 1,2 It is important to include endometriosis in the differential diagnosis of anterior abdominal wall masses, if there is history of previous gynecological surgery.…”

“…3 Most of the times diagnosis can be made in presence of classical history of catamenial exacerbation and cytology, however difficulty may arise as the history of cyclical pain may not always be present. 1,5 The cytological features can be confusing as they depend on the hormonal variation in menstrual cycle and characteristic bimodal pattern may be lacking in smears. 5 Sometimes, smears can be hemorrhagic showing only a few macrophages and inflammatory cells or endometrial stroma leading to misinterpretation as spindle cell neoplasm.…”

“…1,5 The cytological features can be confusing as they depend on the hormonal variation in menstrual cycle and characteristic bimodal pattern may be lacking in smears. 5 Sometimes, smears can be hemorrhagic showing only a few macrophages and inflammatory cells or endometrial stroma leading to misinterpretation as spindle cell neoplasm. 3 In such cases cell block can be of help and may prove as an alternative to biopsy, as it provides earlier and confirmatory diagnosis.…”

“…It is rare and can be diagnosed on the basis of detailed history, careful clinical examination and characteristic cytological features. 5 However sometimes it can be confused with many benign and malignant conditions. 1,5 Delay and misdiagnosis can be avoided by making cell block in the difficult cases.…”

“…5 However sometimes it can be confused with many benign and malignant conditions. 1,5 Delay and misdiagnosis can be avoided by making cell block in the difficult cases. It can also avoid unnecessary discomfort associated with biopsy.…”