Pre-operative diagnosis of scar endometriosis by aspiration cytology

Purpose: Endometriosis is a fairly common disease found in a variety of extra-uterine locations. Abdominal wall scar endometriosis usually presents as a cutaneous or subcutaneous mass which can be investigated easily by the noninvasive method of fine needle aspiration cytology (FNAC). Methods: FNA was performed by a cytopathologist on three patients presenting with varying sized swellings near the cesarean section scar. Results: The cytologic smears revealed a combination of epithelial cells, stromal cells, and variable number of hemosiderin-laden macrophages. A diagnosis of endometriosis was provided on FNAC and later confirmed on histopathology. Conclusions: FNAC is a valuable, cost-effective. and safe tool for diagnosing scar endometriosis and thus permits correct management of the patient.