Endometriosis with colonic mucosal colonisation: a diagnostic confounder.
| Autor: | Adler J; Kaiser Permanente, Oakland, California, USA., Algashaamy K; Jupiter Medical Center, Jupiter, Florida, USA., Garcia de Buitrago MT; University of Miami Miller School of Medicine, Miami, Florida, USA., Pinto A; Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA., Montgomery EA; Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA eam305@med.miami.edu. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of clinical pathology [J Clin Pathol] 2024 Feb 19; Vol. 77 (3), pp. 145-150. Date of Electronic Publication: 2024 Feb 19. |
| DOI: | 10.1136/jcp-2023-209176 |
| Abstrakt: | Aims: Secondary mucosal colonisation by a carcinoma originating from a distant site is a pattern of metastasis to the intestines and hepatobiliary tract and a mimic of primary neoplasia. Although endometriosis is considered benign, its ability to spread widely underscores its quasi-neoplastic nature. After noting that endometriotic glands can colonise the colonic mucosa along the basement membrane, mimicking metastatic disease, we conducted an intradepartmental review of intestinal specimens showing endometriosis obtained from 2016 to 2023 to characterise and quantify the incidence of this phenomenon. Methods: Material from 38 lower gastrointestinal specimens with a primary or ancillary diagnosis of endometriosis was identified from our surgical pathology database. Slides were reviewed, documenting the extent and micro-anatomic location affected by endometriosis, with a focus on identifying examples showing mucosal colonisation. Results: The most common site of involvement was the distal colon (23 cases; 11 of rectum, 9 of sigmoid colon and 3 of rectosigmoid) followed by the appendix (N=10), cecum (N=2), small intestine (N=2) and 'colon not otherwise specified' (N=1). Mucosal involvement was identified in eight cases (21%), half of which demonstrated seamless colonisation of the epithelium by endometriotic glands. In two of these, the procedure was prompted by the presence of a rectal mass or stricture with concern for malignancy. Conclusion: Endometriosis occasionally (4/38; 10.5%) colonises colonic epithelium, potentially mimicking a metastasis or intraepithelial neoplasia/dysplasia. Although unusual, this phenomenon was observed in half of specimens from patients with mucosal involvement in whom a mass or stricture suggested malignancy, a potentially misleading pattern of endometriosis. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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