Güncel Patoloji Dergisi 2018, Cilt 2, Özel Sayı
EPS339(151 - A rare case: ichthyosis uteri with morular metaplasia
Jinekopatoloji
Elif Turan 1, Mustafa Emre Ercin 1, Şafak Ersöz 1, Kübra Öztürk Türker 1, Müşerref Müge Ustaoğlu 1
1 Karadeniz Technical University Faculty Of Medicine
  Introduction:

Endometrial squamous metaplasia occurs in two types; morular or typical keratinized squamous type. The squamous metaplasia of the whole endometrium commonly known as the ichthyosis uteri is a rare phenomenon. We present a case of endometrial morular metaplasia which forms the ichthyosis uteri.

Case Report:

A 35-year-old female patient have menstrual irregularity and was diagnosed with endometrial intraepithelial neoplasia. Hormone releasing intrauterine device was inserted and progestin therapy was applied for 3 months. Then histerectomy operation was performed. Surgical specimen was formalin-fixed and paraffin embedded. The sections were stained with routinary H&E. Immunohistochemistry was performed. Macroscopically, there was locally small bulges on the surface endometrium. Mass lesion wasn’t observed. The thickness of the endometrium was 0.6 cm. Microscopically, extensive squamoid morulae formation seen in the endometrium. The glandular area wasn’t atypical and marked plasma cell infiltration observed in the endometrial stroma. Necrosis was present in the central of morulae, mitotic activity and nuclear atypia were not observed. Immunohistochemically, CDX2 nuclear, Beta-catenin nuclear and cytoplasmic positive and Ki-67 proliferation index was low in the morular areas.

Conclusion:

Squamous metaplasia can occur due to chronic irritation, inflammation, intrauterine foreign substance or accompany malignant diseases. Especially in curettage materials, it may be confused with malignant processes such as squamous cell carcinoma or adenocarcinoma showing squamous differentiation. The lack of mitosis and atypia, low Ki-67 levels are helpful. Metaplasia may be typical keratinized squamous or morular type. For morular metaplasia, nuclear and cytoplasmic positivity of Beta-catenin and nuclear positivity of CDX2 is diagnostic.
Anahtar Kelimeler : Endometrium, squamous, morular, metaplasia