PMC2918835_01
The 2007 biopsy demonstrates noncaseating granulomata, characteristic of sarcoidosis. Sarcoidosis is a diagnosis of exclusion as the finding of granulomata, whether caseating or noncaseating, should result in a clinical and pathologic search for infectious disease, primarily from acid fast bacilli and fungi (200x).
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F1
Moreover, sections of the right lower quadrant abdominal wall were biopsied to rule out malignancy (fig. 1).
A large, complex cystic lesion is noted in the anterior pelvis, displacing the uterus posteriorly.
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F2
During the patient's follow-up examination in May 2009, a 9-cm pelvic mass was detected (fig. 2), although she remained asymptomatic.
The 2009 biopsy shows endometriosis and sarcoid commingling. The pathologic stains were negative for AFB and fungi (400x).
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F3
Frozen section revealed endometriosis, granulomatous inflammation and focal necrosis, with no evidence of malignancy (fig. 3).