Colonic Endometriosis with Extensive Smooth Muscle Metaplasia Simulating Leiomyoma
- Author(s)
- Ilseon Hwang
- Keimyung Author(s)
- Hwang, Il Seon
- Department
- Dept. of Pathology (병리학)
- Journal Title
- Keimyung Medical Journal
- Issued Date
- 2014
- Volume
- 33
- Issue
- 1
- Keyword
- Colon; Endometriosis; Leiomyoma
- Abstract
- It is difficult to distinguish colonic endometriosis with smooth muscle metaplasia from a colonic
neoplasm. Especially, in a small biopsy specimen, marked smooth muscle proliferation can be
misdiagnosed as a spindle cell lesion such as leiomyoma or as a gastrointestinal stromal tumor.
We present the case of a woman aged 48 years who had a colonic polyp, raising suspicion of a
submucosal tumor. In a endoscopic polypectomy specimen, the lesion showed marked smooth
muscle proliferation but in the resection specimen, a nodular mass, composed of endometrial
glands, stroma, and a smooth muscle component, was identified. By immunohistochemical
staining, smooth muscle cells were positive for estrogen receptor, progesterone receptor, smooth
muscle actin, and smooth muscle myosin heavy chain. Endometriosis in the colon can be
misinterpreted as a benign or malignant neoplasm. When examining small biopsy specimens,
clinicians and pathologists should be aware of the potential of this condition to mimic other
intestinal diseases.
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