FNAC Soft Tissues-Endometriosis

Clinical picture:

In 36 y.o. woman it is performer an US-guided FNAC of a round nodular lesion, localized in pericicatriceal region (a history of cesarean section), at the level of anterior abdominal wall and in proximity to the rectus abdominis muscle.


Cytologic picture: 
On a background of mucus and eritrocytes it is abundant cellular population characterized by epithelial component, mostly in cohesive 3D aggregates and by stromal component containing numerous capillaries and a dense population of small cells with round/oval to spindled nuclei.

Fig.1

Fig.1


Fig.2: Stromal cells.

Fig.2: Stromal cells.

Fig.3: Epithelial aggregate.

Fig.3: Epithelial aggregate.

Fig.4a

Fig.4a

Fig.4b

Fig.4b

Tubular epithelial aggregates consisting of monotonous cells with small hyperchromatic nuclei, finely dispersed granular chromatin, nucleoli small or absent and scarse cytoplasm. It is nuclear palisading at the perifery of the aggregates. The morphological and cytological peculiarities are characteristic for proliferative endometrium glands.

Fig.5

Fig.5

Fig.6: Stromal cells.

Fig.6: Stromal cells.


Tubular epithelial 3D structures associated to abundant edematous and cellulated stroma. Cytological picture suggestive of abdominal wall endometriosis.

Fig.7

Fig.7

Fig.8a

Fig.8a

Fig.8b

Fig.8b


Immunohistochemical stains:

Stromal cells are positive for CD10:

Fig.9a

Fig.9a

Fig.9b

Fig.9b

Fig.9c

Fig.9c

Fig.9d

Fig.9d

Cytological diagnosis orients for endometriosis of anterior abdominal wall, diagnosis supported by CD10 positivity in stromal component.

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