Endometriosis in Peritoneal Washings A Potential Diagnostic Pitfall in a Patient with Known Endometrial AdenocarcinomaCheng XM*, Selvarajan S and Mantoo S
Department of Pathology, Singapore General Hospital , Level 10, The Academia, 20 College Road 169856, Singapore
- *Corresponding Author:
- Cheng XM
Department of Pathology
Singapore General Hospital
Level 10, The Academia
20 College Road, Singapore 169856
E-mail: [email protected]
Received Date: Feb 03, 2016; Accepted date: Feb 15, 2016; Published Date: Feb 17, 2016
Citation: Cheng XM, Selvarajan S, Mantoo S (2016) Endometriosis in Peritoneal Washings–A Potential Diagnostic Pitfall in a Patient with KnownEndometrial Adenocarcinoma. J Cytol Histol S5:008. doi:10.4172/2157-7099.S5-008
Copyright: © 2016 Cheng XM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Endometriosis is characterized by the presence of ectopic endometrial tissue outside the uterus, and is an uncommon benign finding in peritoneal washing cytology. Diagnosis of this process is challenging, especially in the context of a known endometrial malignancy, where the presence or absence of peritoneal involvement is believed to have prognostic implications. In such cases, it is important to accurately distinguish between endometriosis and welldifferentiated metastatic malignancy. We discuss the case of a 68-year old woman who underwent staging surgery, including peritoneal washing cytology, for biopsy-proven endometrioid adenocarcinoma of the endometrium. Peritoneal washing cytology showed hallmark features of endometriosis, namely occasional ball-like clusters lined by columnar cells and containing central endometrial stromal-like cells, on a background of blood and haemosiderophages. Positive CD10 immunocytochemistry confirmed the presence of endometrial stroma. These findings, when taken together with cytological features and lack of significant cytologic atypia, further supported a diagnosis of endometriosis. Review of histopathology slides from the THBSO specimen confirmed the presence of ovarian and cervical endometriosis. In conclusion, distinguishing between endometriosis and endometrial adenocarcinoma in peritoneal washing cytology requires a combination of identification of salient cytological features and correlation with clinical information and histopathological findings.