RESUMO
We describe a preconception hysteroscopic image of a patient with a ruptured uterus at 27 weeks' gestation. A 40-year-old gravida 2, para 1, underwent open adenomyomectomy because of infertility. Subsequently, hysteroscopy performed at our hospital revealed an endometrial deficit from the uterine fundus to the posterior wall, and an area where the endometrium was missing and composed of yellow tissue was seen. She later achieved pregnancy. Lower abdominal pain occurred on day 1 of the 27th week of pregnancy. She suddenly went into a state of shock. Emergency laparotomy was performed, and a uterine rupture wound of approximately 10 cm in the longitudinal direction was seen in the posterior wall. A 1120-g male infant was stillborn. Total blood loss was 6450 mL. The mother was saved without hysterectomy. After adenomyomectomy, a hysteroscopy should be performed to check for endometrial defects before allowing pregnancy.
RESUMO
Alveolar rhabdomyosarcoma (ARMS) is a nonepithelial tumor with skeletal muscle differentiation and typically affects adolescents and young adults. The cytological features of ARMS in body fluid have not been well characterized, which complicates diagnosis. Here, we describe the cytological features of ARMS in the ascites of a 50-year-old woman with an intra-abdominal mass and abundant ascites. Aspiration cytology of ascitic fluid revealed numerous small discohesive round cells with mild nuclear atypia and prominent nucleoli. Rhabdomyoblastic cells, characteristic of rhabdomyosarcoma, were identified rarely. Cannibalism and 'window' formation, as seen in reactive mesothelial cells, complicated the diagnosis of ARMS. Histological examination established the diagnosis of ARMS, which was confirmed by immunohistochemical expression of myogenic markers. When diagnosing ARMS from effusion samples, the diagnostic problems associated with the morphological similarity of ARMS cells to reactive mesothelial cells should be considered.