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Presented by Pedram Argani, M.D. and prepared by Hillary Ross, M.D.
Case 1: This is a 51 year old female with a strictured colonic mass.
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Question 1 of 1
1. Question
Week 474: Case 1
This is a 51 year old female with a strictured colonic mass.images/1Alex/04052011case1image1.jpg
images/1Alex/04052011case1image2.jpg
images/1Alex/04052011case1image3.jpgCorrect
Answer: Endometriosis
Histology: Within the strictured area, characterized by smooth muscle thickening, there are bland glands with columnar nuclei set in a hypocellular, edematous, bland stroma. Intracellular mucin is not identified within the epithelium in this lesion. These are the typical features of endometriosis.
Discussion: Adenocarcinoma would demonstrate greater cytologic atypia than the current lesion, and would lack the characteristic endometrial stroma. Adenomatous polyps may demonstrate pseudoinvasion; however, this is typically associated with hemosiderin deposition and the stroma is that of the lamina propria, which is different from the endometrial stroma seen in the current lesion. Mesothelial cysts are composed of bland cuboidal epithelium which may be flat and attenuated, and is not associated with endometrial stroma.
Reference(s):
– Clement PB. Advances in Anatomic Pathology 2007; 14:241-260.Incorrect
Answer: Endometriosis
Histology: Within the strictured area, characterized by smooth muscle thickening, there are bland glands with columnar nuclei set in a hypocellular, edematous, bland stroma. Intracellular mucin is not identified within the epithelium in this lesion. These are the typical features of endometriosis.
Discussion: Adenocarcinoma would demonstrate greater cytologic atypia than the current lesion, and would lack the characteristic endometrial stroma. Adenomatous polyps may demonstrate pseudoinvasion; however, this is typically associated with hemosiderin deposition and the stroma is that of the lamina propria, which is different from the endometrial stroma seen in the current lesion. Mesothelial cysts are composed of bland cuboidal epithelium which may be flat and attenuated, and is not associated with endometrial stroma.
Reference(s):
– Clement PB. Advances in Anatomic Pathology 2007; 14:241-260.
