2018 Volume 57 Issue 2 Pages 120-124
Background : We report a case of ileocecal endometriosis diagnosed by intraoperative fine needle aspiration cytology (IFNAC).
Case : A 32-year-old nulligravid and nulliparous woman was referred to our hospital because of clinical suspicion of intestinal obstruction. She had a past history of right oophorectomy, and the symptoms suggestive of intestinal obstruction increased with menstruation. We performed ileocecal resection under suspicion of adhesive intestinal obstruction due to intestinal endometriosis. The resected segment of the intestine showed a submucosal tumor. IFNAC of this tumor revealed epithelial cell clusters. In addition, scattered isolated, as well as aggregated stromal cells were observed in the background. The endometrial glands showed metaplastic changes, but no evidence of atypia. Microscopically, islands composed of endometrial glands and stroma were observed in the submucosa, muscle layer, and subserosa. No cytological and/or structural atypia was identified. Immunohistochmically, these endometrial glands were positive for ER, PgR and CK7, and negative for CK20. The stromal cells were positive for CD10. Therefore, we made the diagnosis of ileocecal endometriosis.
Conclusion : We encountered a case of ileocecal endometriosis. It is important to screen the cytology specimen in detail and carefully consider the clinical history for making a precise diagnosis of endometriosis, since endometriosis can occur in various organs, including the intestine.
