title: Cytomorphological spectrum in scar endometriosis: a study of eight cases.
abstract: OBJECTIVE
  Endometriosis due to ectopic endometrial tissue that responds to hormonal stimulation and is extremely rare in a surgical scar appearing in 0.1% of women who have undergone Caesarean section. Fine needle aspiration cytology (FNAC) can be a valuable diagnostic aid in the evaluation of these subcutaneous abdominal masses.
  
  
  METHODS
  We present the cytomorphological spectrum in eight cases of abdominal wall endometriosis diagnosed by FNAC over a 6-year period (June 1998-June 2004) in Mubarak Al-Kabeer Hospital (Kuwait). The patients ranged from 27 to 56 years of age. Seven had a prior Caesarean section and one had a hysterectomy for fibroid. They presented 3-8 years later with nodules in/near the abdominal scar. Five cases presented with a painful nodule, fluctuant with the menstrual cycle.
  
  
  RESULTS
  Cytological findings comprised epithelial clusters and fusiform stromal cells with numerous haemosiderin-laden macrophages. Mild to moderate epithelial atypia was observed in three cases. A diagnosis of endometriosis was rendered in all the eight cases and tissue was available in four cases.
  
  
  CONCLUSIONS
  Endometriotic nodules need to be differentiated from other benign/malignant masses and evaluated for possible malignant transformation. FNAC provides a safe and effective tool for diagnosis thereby obviating the need for other procedures.
authors.affiliation: Mubarak Al-Kabeer Hospital, Kuwait University, Kuwait.
authors.forename: S K
authors.initials: SK
authors.lastname: Pathan
authors.forename: K
authors.initials: K
authors.lastname: Kapila
authors.forename: B E
authors.initials: BE
authors.lastname: Haji
authors.forename: M K
authors.initials: MK
authors.lastname: Mallik
authors.forename: T A
authors.initials: TA
authors.lastname: Al-Ansary
authors.forename: S S
authors.initials: SS
authors.lastname: George
authors.forename: D K
authors.initials: DK
authors.lastname: Das
authors.forename: I M
authors.initials: IM
authors.lastname: Francis
mesh_terms: D000005:Abdomen; D000328:Adult; D044963:Biopsy, Fine-Needle; D002585:Cesarean Section; D002921:Cicatrix / Q000473:pathology*; D004715:Endometriosis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008264:Macrophages / Q000473:pathology; D008875:Middle Aged; D017154:Stromal Cells / Q000473:pathology