1/63. Multiple endometrial stromal nodules with sparse cysts and glands in the lung--a nodular variation of endometriosis that may mimic metastases of sarcoma.We report an unusual case of a nodular variation of pulmonary endometriosis. To our knowledge, there is no previous report on a morphological investigation of this entity. The etiology of this rare condition is still a matter of discussion. The well-circumscribed nodular mass is composed of cells identical to, or closely resembling, those of endometrial stroma containing sparse cysts and glands. Immunohistochemically, the cells showed an extensive co-expression of cytokeratin AE1/AE3 and vimentin and were highly positive for progesterone receptor (PRICA) and estrogen receptor (ERICA). Cells lining the cysts and glands as a monolayer were reactive for Ber-Ep4, cytokeratin Pan and cytokeratin AE1/AE3 and negative to all other markers used including PRICA and ERICA. The differential diagnosis of this entity included fibrous tumor of the pleura and metastatic low-grade-endometrial-stromal-sarcoma. The morphological findings are correlated with immunohistochemical studies and results of cell image analysis. This study details the clinicopathological features of the nodular variation of pulmonary endometriosis.- - - - - - - - - - ranking = 1keywords = endometrial stromal, stromal (Clic here for more details about this article) |
2/63. Stromal sarcoma arising on endometriosis. A clinicopathological and immunohistochemical study of 4 cases.The development of stromal sarcomas on the foci of endometriosis is extremely rare and the differential diagnosis from other tumors of myogenic, vascular, hemopoietic or epithelial origin may present great diagnostic difficulties. We investigated the clinicopathological and immunohistochemical characteristics of 4 cases of endometrial stromal sarcoma that developed on endometriotic foci of the uterus, vagina and omentum. Thye were classed as high grade (1/4) or low grade (3/4) malignant potential tumors, according to their mitotic activity. Immunohistochemically these tumors gave a positive reaction to vimentin, but were negative to desmin, smooth muscle actin, factor viii, EMA and LCA. These characteristics permit their identification and a proper therapeutic approach.- - - - - - - - - - ranking = 0.25079059531771keywords = endometrial stromal, stromal (Clic here for more details about this article) |
3/63. Catamenial pneumothorax caused by diaphragmatic stromal endometriosis.A case of catamenial pneumothorax caused by stromal endometriosis of the diaphragm is described. A 40-year-old woman suffered two episodes of right-sided pneumothorax which occurred after onset of menstruation. thoracoscopy revealed brownish spots in the right diaphragm and partial excision of the diaphragm was performed. Histological examination showed that the lesion was characterized by sheets of cells resembling endometrial stromal cells, small thin-walled blood vessels and extravasated erythrocytes in varying proportions. Some clusters of these cells were transmural. No endometrial-type glands were found. Immunohistochemically, the nuclei of the endometrial stromal cells were strongly positive for both estrogen and progesterone receptors. Therapy with a gonadotropin-releasing hormone analogue was started and the patient has since been asymptomatic for 6 months. Pathologists should not overlook diaphragmatic stromal endometriosis as a possible cause of pneumothorax.- - - - - - - - - - ranking = 0.50579769899657keywords = endometrial stromal, stromal (Clic here for more details about this article) |
4/63. Cervical/vaginal endometriosis with atypia: A cytohistopathologic study.Neoplastic or atypical glandular epithelial cells of uncertain significance were reported in the preoperative smears from 10 women with cervical or vaginal endometriosis. Subsequent conization and vaginal biopsy revealed endometriotic tissue with variable epithelial atypia, but no evidence of in situ or invasive carcinoma. review of the smears revealed appearances similar to those seen in "high cervical sampling" or in smears from patients with tubal metaplasia. The presence of large cohesive cell sheets with retained cell polarity and well-defined cytoplasmic edges, of endometrial cell "whorls" and tubular structures, and of endometrial-like stromal cells coupled with the absence of three-dimensional cell clusters, peripheral cell-sheet crowding, "cell feathering," and pseudostratified cell strips are features helpful in the distinction between cervical/vaginal endometriosis and adenocarcinoma. Diagn. Cytopathol. 1999;21:188-193.- - - - - - - - - - ranking = 0.001054127090285keywords = stromal (Clic here for more details about this article) |
5/63. Vaginal adenosarcoma arising from endometriosis.OBJECTIVE: Malignant transformation of endometriosis has been well documented. Endometrioid adenocarcinoma is the most common malignancy to occur in this setting, although other carcinomas and rarely stromal tumors can be seen. We present the first case in the literature of adenosarcoma, a rare mixed mullerian or mesodermal tumor, arising in extrauterine vaginal endometriosis. CASE: A 42-year-old woman underwent multiple medical therapies and surgeries for aggressive endometriosis. A pelvic exenteration was abandoned secondary to severe fibrosis, and low-dose radiotherapy was used to control bleeding from vaginal endometriosis. The pathologic diagnosis of recurrent endometriosis was confirmed multiple times over her 4-year course. Excision of a recurrent vaginal mass revealed adenosarcoma with heterologous elements. CONCLUSION: It is important to biopsy or excise recurrent endometriosis, as malignant transformation can occur, giving rise to epithelial, stromal, or mixed epithelial-mesenchymal tumors.- - - - - - - - - - ranking = 0.00210825418057keywords = stromal (Clic here for more details about this article) |
6/63. Effects of leuprolide acetate on low-grade endometrial stromal sarcoma.We describe a low-grade endometrial stromal sarcoma coexistent with leiomyoma and adenomyosis treated with leuprolide acetate. We describe its histologic characteristics and clinical significance.- - - - - - - - - - ranking = 1.2486823411371keywords = endometrial stromal, stromal (Clic here for more details about this article) |
7/63. endometriosis-associated intestinal tumors: a clinical and pathological study of 6 cases with a review of the literature.This clinicopathologic study of primary Mullerian tumors of the bowel arising in foci of endometriosis is based on six new cases and an analysis of 17 previously reported cases. Varieties of Mullerian tumors occur in the bowel; the most common types are endometrioid carcinoma, followed by various mixed Mullerian tumors and stromal sarcomas. Seventy-eight percent develop in the rectosigmoid colon, the remaining in the cecum or ileum. Those in the latter area tend to be sarcomas or mixed Mullerian tumors. Certain architectural growth characteristics, derived from precursor endometriosis, are common to most endometriosis-associated intestinal tumors (EAITs). Seventy percent of EAITs occur in the outer bowel wall. Transmural tumors tend to form luminal polyps and assume an hourglass shape. Metachronous or synchronous Mullerian tumors occur in 39% of cases. Seventy percent of women with EAITs are in their mid 30s to early 50s. Common presenting symptoms are abdominal or pelvic pain, melena, and an abdominal or pelvic mass. Documented in 26% of patients is a history of prolonged unopposed estrogen therapy. Only 28.5% of cases die of their tumors, but follow-up is less than 5 years in all but 2 patients.- - - - - - - - - - ranking = 0.001054127090285keywords = stromal (Clic here for more details about this article) |
8/63. pregnancy associated endometriosis with pronounced stromal myxoid change.A case of endometriosis presenting as a mass in the groin of a pregnant woman is described. The mass increased in size during the pregnancy and the radiological features were suspicious of malignancy. Histological examination showed atrophic glands set in an abundant stroma. This was not typical of normal endometrial stroma but had a pronounced myxoid appearance with areas of decidualization. The atypical site of the endometriosis together with the unusual stromal changes resulted in diagnostic confusion. Although stromal decidualization is well recognized in endometriosis in pregnancy, pronounced myxoid change appears unusual. The myxoid change in this case may be a degenerative phenomenon related to pregnancy.- - - - - - - - - - ranking = 0.0063247625417099keywords = stromal (Clic here for more details about this article) |
9/63. adenomyosis with a sex cord-like stromal element.A case of adenomyosis with a sex cord-like stromal element is described. The element was an incidental, solitary, microscopic finding in a focus of adenomyosis. It was characterized by cord and trabecular arrangements of round to polygonal shaped cells in the endometrioid stroma. The cells were immunohistochemically positive for desmin and alpha-smooth muscle actin but negative for sex cord markers (alpha-inhibin and O13). The element appears to originate from the endometrial stromal cells through smooth muscle metaplasia.- - - - - - - - - - ranking = 0.25500710367885keywords = endometrial stromal, stromal (Clic here for more details about this article) |
10/63. Endometrial stromal sarcoma of the vagina.Endometrial stromal sarcoma is a rare tumor and has unique histopathologic features. Most tumors of this kind occur in the uterus; thus, the vagina is an extremely rare site. A 34-year-old woman presented with endometrial stromal sarcoma arising in the vagina. No correlative endometriosis was found. Because of the uncommon location, this tumor was differentiated from other more common neoplasms of the vagina, particularly embryonal rhabdomyosarcoma and other smooth muscle tumors. Although the pathogenesis of endometrial stromal tumors remains controversial, the most common theory of its origin is heterotopic Mullerian tissue such as endometriosis tissue. Primitive cells of the pelvis and retroperitoneum are an alternative possible origin for the tumor if endometriosis is not present. According to the literature, the tumor has a fairly good prognosis compared with other vaginal sarcomas. Surgery combined with adjuvant radiotherapy appears to be an adequate treatment.- - - - - - - - - - ranking = 0.50474357190628keywords = endometrial stromal, stromal (Clic here for more details about this article) |
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