Arias-Stella reaction in an adenomyomatous polyp of the uterus
ABSTRACT We describe a rare case of an Arias-Stella reaction in an adenomyomatous polyp of the endometrium found in the first trimester of pregnancy. A 33-year-old Japanese woman, gravida 1, para 1, presented for an initial prenatal examination at 6-week gestation; ultrasound revealed a myoma-like solid mass in the cervical canal. An abnormal Papanicolaou's smear (highly suspicious of adenocarcinoma) prompted the resection of this pedunculated polyp. Histologically, the musculature located in the center of the polyp was covered by the endometrium; numerous glands within both the endometrium and the musculature exhibited an Arias-Stella reaction. This explains the result of Papanicolaou's smear, because subsequent smears - both intrapartum and postpartum - were negative. To our knowledge, this is the first reported incident of an Arias-Stella reaction in an adenomyomatous polyp. This could be one of the diagnostic pitfalls in Papanicolaou's smears taken during pregnancy.
SourceAvailable from: Costas Panayotidis[Show abstract] [Hide abstract]
ABSTRACT: The finding of a cervical polyp during pregnancy is uncommon condition. In some cases a polyp can be symptomatic, in others it is an incidental finding during vaginal examination. However in both situations it can be a cause of major anxiety for the pregnant woman. The management depends on the symptoms. Most of the time, the conservative approach is the management of choice. In this article we have tried to review the recent evidence and propose a management algorithm that can be used as a guide to explain to the patient the treatment options available and the rationale behind them.
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ABSTRACT: Adenomyomatous polyps of the endometrium are a rare subtype of endometrial polyps. In addition to the usual features of endometrial polyps, they also contain a smooth muscle component. Grossly they appear no different than ordinary endometrial polyps. In the case reported herein, a 23-year-old nulliparous female was killed in a traffic accident. In the course of the medicolegal autopsy, a small pedunculated growth was identified in the fundus of the endometrial cavity. Histologically the mass consisted of endometrial glands intimately mixed with smooth muscle and thick walled blood vessels, consistent with an adenomyomatous polyp. There was no history of tamoxifen use in this individual. To our knowledge this is the first report of post-mortem diagnosis of an adenomyomatous polyp. Furthermore, this is the first report of an individual with this diagnosis younger than the fourth decade. In the medicolegal setting, forensic pathologists are constantly faced with entities that, while they may not have caused death, may serve to educate practitioners about rare lesions. This individual's finding serves as one of those entities. This case reiterates the importance of the autopsy as not only the answer to an individual's death, but as an avenue for the discovery of entities that may have relevance to those who are still living.Journal of Forensic and Legal Medicine 05/2012; 19(4):236-8. DOI:10.1016/j.jflm.2012.02.003 · 0.99 Impact Factor
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ABSTRACT: Peutz-Jeghers syndrome, which has autosomal dominant inheritance, shows pigmentation in lip and skin. It also has features of harmatomatous polyp over the gastrointestinal tract, while sometimes developing tumor in genital tract. Known tumors in female genital tract include cervical adenocarcinoma, sex cord tumor, etc. Adenomyomatous polyp in uterus is also one of the rare diseases, which seldom develop in the absence of hormone treatment such as Tamoxifen. Currently, there is one case of Peutz-Jeghers syndrome patient with endometrial adenomyomatous polyp. Authors found mole-like lesions on the transvaginal ultrasonogram in a typical Peutz-Jeghers syndrome patient without pregnancy history and previous chemotherapy. After confi rming its diagnosis of adenomyomatous polyp on resectoscopic biopsy, we report our fi ndings along with brief literature review. Th is is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.01/2011; 54(2). DOI:10.5468/KJOG.2011.54.2.115