Endometrial foam Cells: Non-estrogenic and estrogenic

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Abstract
Four patients with endometrial foam cells are described. In 1 the endometrium was obtained after parturition. It showed decidua and endometritis, whereas in the 2nd patient, who had received birth control medication in the past, the endometrium was proliferative. In both cases there was a considerable amount of endometrial hemorrhage. The foam cells in these 2 patients had little granularity, and their cytoplasm contained hemosiderin. The other 2 patients received exogenous estrogen and presented with endometrial hyperplasia and adenocarcinoma. In these latter cases the foam cells were more granular, and contained no hemosiderin. The presence of 2 types of histologically similar endometrial foam cells: a histiocytic, non-estrogenic reactive type capable of phagocytosis, and a stromal, estrogenic non-phagocytic type which is associated with hyperplasia or carcinoma and which may also be related to estrogen administration. Staining for hemosiderin may be particularly helpful in differentiating between the 2 types of foam cell. Such a differentiation is of practical importance because of the biologic significance attached to the estrogenic foam-cells which are usually indicative of endometrial hyperplasia or carcinoma.

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