Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens
ABSTRACT We report for the first time a case of 2.5 cm polypoid cervical endometriosis with a superficial growth pattern in a 48-year-old patient with past tubal ligation. The lesion showed metaplastic changes (clear cell, eosinophilic, micropapillary) and a prominent Arias Stella reaction in the absence of concomitant pregnancy but presumably related to phytoestrogenic treatment. The eutopic endometrium, however, had a usual proliferative appearance, implying that it showed a different response from the endometriotic tissues, suggesting the possibility of a metaplastic origin for the endocervical polypoid endometriosis. The unusual histology of the lesion led to an erroneous diagnosis of papillary serous carcinoma in the biopsy. This was subsequently excluded on finding endometrial-type stroma surrounding glands, and was confirmed immunohistochemically by a low Ki-67 index and negativity for p53.
Full-textDOI: · Available from: Francisco F Nogales, Aug 12, 2015
- Ground Penetrating Radar, 2004. GPR 2004. Proceedings of the Tenth International Conference on; 02/2004
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ABSTRACT: Aim: To confirm the hypothesis of the presence of a possible endometriosis inducing factor(s) (EIF) in the blood of women with endometriosis. Patients and Methods: Forty infertile women were studied. The study group compromised of fifteen women of each three different degrees of endometriosis and fifteen women without endometriosis as a control group. Stem cells are characterized by being spindle shaped and proliferate in appropriate culture indefinitely. The women sera were co-cultured with mesenchymal stem cells (MSCs) which were followed up weekly to look for morphological changes and to detect Annexin 1 marker and ß-actin gene by reverse transcriptase polymerase chain reaction. Results: MSCs cultured with sera of cases with, mild, moderate and severe endometriosis, showed morphological changes to be columnar and cuboidal shaped cells -resembling endometrial cells and glands- by the 4th week in 60%, 60% & 100% respectively. These cells were detected from as early as the first week in women with moderate and severe types (20% for each group). The percentage of the change into endometrial like cells increased among the three groups where it was 30±25.8%, 45±29.9% and 75±37.9% respectively. Moreover, increasing number of endometrial like cells are detected weekly, the more severe the disease is. None of the cultures of serum of the control group had made such changes all over the study. Furthermore, with more differentiation there was a considerable decrease in number of stem cells. These differentiated cells expressed the Annexin-1 marker. Conclusion: It was evident that serum of women with endometriosis posses a factor(s) that enables the MSCs to be transformed into endometrial like cells and glands in vitro. This finding supports a new theory for the etiology of endometriosis. This observation may have a tremendous effect on the therapeutic implications of this debilitating condition.10/2010; 6(3):157-64.
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ABSTRACT: The purpose of this study was to analyze the clinicopathologic characters and explore the possible cause of cervical endometriosis. By retrospective review, among 13,566 cases of endometriosis that had been treated in our hospital, 33 cases of pathologically proven cervical endometriosis were extracted. Of 33 cases, 17 women had abnormal vaginal bleeding or visible cervical lesions; the other 16 women had no obvious clinical manifestations but were diagnosed retrospectively on histopathologic reports. Vaginal delivery or curettage procedures had occurred in 84.8% of patients. Only 2 patients had undergone cervical surgery of cryotherapy or electric excision. Seven cases were misdiagnosed before final surgery with the primary suspicion of cervical myoma, inflammatory cyst, cervical polyp, uterine submucous myoma, melanoma or melanin mole, and cervical cancer. Surgical treatment was performed for all symptomatic patients. No recurrence was seen. Cervical endometriosis should be distinguished from other benign or malignant cervical lesions. Surgical excision is suggested for symptomatic patients.American journal of obstetrics and gynecology 06/2011; 205(5):452.e1-5. DOI:10.1016/j.ajog.2011.06.070