{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:42:13Z","timestamp":1789688533758,"version":"4.0.1"},"reference-count":28,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ectopic decidua is one of several benign lymph node inclusions that have been increasingly documented in the literature, most often in postmortem examinations of pregnant woman and recently in pregnant women with cervical squamous cell carcinoma. Although lacking clinical significance of its own, the major diagnostic implication would be misdiagnosis as metastatic carcinoma in the lymph node. Intraoperative frozen sections are often performed prior to radical hysterectomy, leading to a potential alteration of therapy if metastatic carcinoma is identified in the lymph nodes. We report such a case of a pregnant woman with cervical squamous cell carcinoma requiring lymphadenectomy and hysterectomy, in which the intraoperative frozen section of a pelvic lymph node with ectopic decidual change was mistakenly identified as metastatic carcinoma. Its histologic resemblance to carcinoma and location within subcapsular sinuses, compounded with the fact that ectopic lymph node decidua is not commonly seen in routine practice, can lead to this diagnostic pitfall. We review the literature regarding ectopic decidua, its presence in lymph nodes, and its pathogenesis, as well as review the literature on benign lymph node inclusions.<\/jats:p>","DOI":"10.5858\/2005-129-e117-edopln","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T19:27:13Z","timestamp":1612985233000},"page":"e117-e120","source":"Crossref","is-referenced-by-count":25,"title":["Ectopic Decidua of Pelvic Lymph Nodes: A Potential Diagnostic Pitfall"],"prefix":"10.5858","volume":"129","author":[{"given":"Debbie C.","family":"Wu","sequence":"first","affiliation":[{"name":"From the Department of Pathology, University of California, Los Angeles. Dr Wu is currently a staff pathologist at Pacific Pathology Associates, Salem Hospital\/Pathology, Salem, Ore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Hirschowitz","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, University of California, Los Angeles. Dr Wu is currently a staff pathologist at Pacific Pathology Associates, Salem Hospital\/Pathology, Salem, Ore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathima","family":"Natarajan","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, University of California, Los Angeles. Dr Wu is currently a staff pathologist at Pacific Pathology Associates, Salem Hospital\/Pathology, Salem, Ore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"key":"i1543-2165-129-5-e117-b1","series-title":"J Surg Oncol","first-page":"6","article-title":"Ectopic decidual cell reaction in para-aortic and pelvic lymph nodes in the presence of cervical squamous cell carcinoma during pregnancy.","volume":"26","author":"Ashraf, M.","year":"1984","unstructured":"Ashraf, M., C. B.Boyd, and W. A.Beresford. Ectopic decidual cell reaction in para-aortic and pelvic lymph nodes in the presence of cervical squamous cell carcinoma during pregnancy.J Surg Oncol1984. 26:6\u20138."},{"key":"i1543-2165-129-5-e117-b2","series-title":"Am J Surg Pathol","first-page":"526","article-title":"Pregnancy-associated ectopic decidua.","volume":"11","author":"Zaytsev, P.","year":"1987","unstructured":"Zaytsev, P. and J. B.Taxy. Pregnancy-associated ectopic decidua.Am J Surg Pathol1987. 11:526\u2013530."},{"key":"i1543-2165-129-5-e117-b3","series-title":"Surg Gynecol Obstet","first-page":"218","article-title":"Decidual reaction of endometrium ectopic in an abdominal lymph node.","volume":"81","author":"Russell, H. B.","year":"1945","unstructured":"Russell, H. B.\n          \n          Decidual reaction of endometrium ectopic in an abdominal lymph node.\n          Surg Gynecol Obstet\n          1945. 81:218\u2013220."},{"key":"i1543-2165-129-5-e117-b4","series-title":"Obstet Gynecol","first-page":"824","article-title":"Decidua in pelvic lymph nodes: report of a case.","volume":"29","author":"Winkelstein, C. E.","year":"1967","unstructured":"Winkelstein, C. E., A. D.Nicastri, and S.Minkowitz. Decidua in pelvic lymph nodes: report of a case.Obstet Gynecol1967. 29:824\u2013827."},{"key":"i1543-2165-129-5-e117-b5","series-title":"Histopathology","first-page":"1089","article-title":"Decidual change in pelvic lymph nodes: a source of possible diagnostic error.","volume":"10","author":"Burnett, R. A.","year":"1986","unstructured":"Burnett, R. A. and D.Millan. Decidual change in pelvic lymph nodes: a source of possible diagnostic error.Histopathology1986. 10:1089\u20131092."},{"key":"i1543-2165-129-5-e117-b6","series-title":"Int J Gynecol Pathol","first-page":"209","article-title":"Decidua and squamous metaplasia in abdominopelvic lymph nodes.","volume":"2","author":"Mills, S. E.","year":"1983","unstructured":"Mills, S. E.\n          \n          Decidua and squamous metaplasia in abdominopelvic lymph nodes.\n          Int J Gynecol Pathol\n          1983. 2:209\u2013215."},{"key":"i1543-2165-129-5-e117-b7","series-title":"J Surg Oncol","first-page":"126","article-title":"Ectopic decidua and metastatic squamous carcinoma: presentation in a single pelvic lymph node.","volume":"38","author":"Cobb, C. J.","year":"1988","unstructured":"Cobb, C. J.\n          \n          Ectopic decidua and metastatic squamous carcinoma: presentation in a single pelvic lymph node.\n          J Surg Oncol\n          1988. 38:126\u2013129."},{"key":"i1543-2165-129-5-e117-b8","series-title":"Am J Obstet Gynecol","first-page":"780","article-title":"The spread of benign and malignant endometrium in the lymphatic system with a note on coexisting vascular involvement.","volume":"64","author":"Javert, C. T.","year":"1952","unstructured":"Javert, C. T.\n          \n          The spread of benign and malignant endometrium in the lymphatic system with a note on coexisting vascular involvement.\n          Am J Obstet Gynecol\n          1952. 64:780\u2013806."},{"key":"i1543-2165-129-5-e117-b9","series-title":"Arch Pathol","first-page":"698","article-title":"Neoplasms of the subcoelomic mesenchyme.","volume":"59","author":"Ober, W. B.","year":"1955","unstructured":"Ober, W. B. and M. B.Black. Neoplasms of the subcoelomic mesenchyme.Arch Pathol1955. 59:698\u2013705."},{"key":"i1543-2165-129-5-e117-b10","series-title":"J Pathol","first-page":"301","article-title":"Benign lymph node inclusions.","volume":"173","author":"Rutty, G. N.","year":"1994","unstructured":"Rutty, G. N.\n          \n          Benign lymph node inclusions.\n          J Pathol\n          1994. 173:301\u2013302."},{"key":"i1543-2165-129-5-e117-b11","series-title":"Am J Clin Pathol","first-page":"741","article-title":"Mesothelial cell inclusions in mediastinal lymph nodes mimicking metastatic carcinoma.","volume":"93","author":"Brooks, J. S. J.","year":"1990","unstructured":"Brooks, J. S. J., V. A.LiVolsi, and G. G.Pietra. Mesothelial cell inclusions in mediastinal lymph nodes mimicking metastatic carcinoma.Am J Clin Pathol1990. 93:741\u2013748."},{"key":"i1543-2165-129-5-e117-b12","series-title":"Am J Surg Pathol","first-page":"1264","article-title":"Benign mesothelial cells in mediastinal lymph nodes.","volume":"23","author":"Parkash, V.","year":"1999","unstructured":"Parkash, V., M.Vidwans, and D.Carter. Benign mesothelial cells in mediastinal lymph nodes.Am J Surg Pathol1999. 23:1264\u20131269."},{"key":"i1543-2165-129-5-e117-b13","series-title":"Pathol Res Pract","first-page":"991","article-title":"Frequency and histogenesis of pelvic retroperitoneal lymph node inclusions of the female genital tract: an immunohistochemical study of 34 cases.","volume":"191","author":"Horn, L. C.","year":"1995","unstructured":"Horn, L. C. and K.Bilek. Frequency and histogenesis of pelvic retroperitoneal lymph node inclusions of the female genital tract: an immunohistochemical study of 34 cases.Pathol Res Pract1995. 191:991\u2013996."},{"key":"i1543-2165-129-5-e117-b14","series-title":"Arch Pathol Lab Med","first-page":"841","article-title":"Benign m\u00fcllerian lymph node inclusions: an unusual case with implications for pathogenesis and review of the literature.","volume":"119","author":"Henley, J. D.","year":"1995","unstructured":"Henley, J. D., H. B.Michael, G. W.English, and L. M.Roth. Benign m\u00fcllerian lymph node inclusions: an unusual case with implications for pathogenesis and review of the literature.Arch Pathol Lab Med1995. 119:841\u2013844."},{"key":"i1543-2165-129-5-e117-b1","series-title":"J Surg Oncol","first-page":"6","article-title":"Ectopic decidual cell reaction in para-aortic and pelvic lymph nodes in the presence of cervical squamous cell carcinoma during pregnancy.","volume":"26","author":"Ashraf, M.","year":"1984","unstructured":"Ashraf, M., C. B.Boyd, and W. A.Beresford. Ectopic decidual cell reaction in para-aortic and pelvic lymph nodes in the presence of cervical squamous cell carcinoma during pregnancy.J Surg Oncol1984. 26:6\u20138."},{"key":"i1543-2165-129-5-e117-b2","series-title":"Am J Surg Pathol","first-page":"526","article-title":"Pregnancy-associated ectopic decidua.","volume":"11","author":"Zaytsev, P.","year":"1987","unstructured":"Zaytsev, P. and J. B.Taxy. Pregnancy-associated ectopic decidua.Am J Surg Pathol1987. 11:526\u2013530."},{"key":"i1543-2165-129-5-e117-b3","series-title":"Surg Gynecol Obstet","first-page":"218","article-title":"Decidual reaction of endometrium ectopic in an abdominal lymph node.","volume":"81","author":"Russell, H. B.","year":"1945","unstructured":"Russell, H. B.\n          \n          Decidual reaction of endometrium ectopic in an abdominal lymph node.\n          Surg Gynecol Obstet\n          1945. 81:218\u2013220."},{"key":"i1543-2165-129-5-e117-b4","series-title":"Obstet Gynecol","first-page":"824","article-title":"Decidua in pelvic lymph nodes: report of a case.","volume":"29","author":"Winkelstein, C. E.","year":"1967","unstructured":"Winkelstein, C. E., A. D.Nicastri, and S.Minkowitz. Decidua in pelvic lymph nodes: report of a case.Obstet Gynecol1967. 29:824\u2013827."},{"key":"i1543-2165-129-5-e117-b5","series-title":"Histopathology","first-page":"1089","article-title":"Decidual change in pelvic lymph nodes: a source of possible diagnostic error.","volume":"10","author":"Burnett, R. A.","year":"1986","unstructured":"Burnett, R. A. and D.Millan. Decidual change in pelvic lymph nodes: a source of possible diagnostic error.Histopathology1986. 10:1089\u20131092."},{"key":"i1543-2165-129-5-e117-b6","series-title":"Int J Gynecol Pathol","first-page":"209","article-title":"Decidua and squamous metaplasia in abdominopelvic lymph nodes.","volume":"2","author":"Mills, S. E.","year":"1983","unstructured":"Mills, S. E.\n          \n          Decidua and squamous metaplasia in abdominopelvic lymph nodes.\n          Int J Gynecol Pathol\n          1983. 2:209\u2013215."},{"key":"i1543-2165-129-5-e117-b7","series-title":"J Surg Oncol","first-page":"126","article-title":"Ectopic decidua and metastatic squamous carcinoma: presentation in a single pelvic lymph node.","volume":"38","author":"Cobb, C. J.","year":"1988","unstructured":"Cobb, C. J.\n          \n          Ectopic decidua and metastatic squamous carcinoma: presentation in a single pelvic lymph node.\n          J Surg Oncol\n          1988. 38:126\u2013129."},{"key":"i1543-2165-129-5-e117-b8","series-title":"Am J Obstet Gynecol","first-page":"780","article-title":"The spread of benign and malignant endometrium in the lymphatic system with a note on coexisting vascular involvement.","volume":"64","author":"Javert, C. T.","year":"1952","unstructured":"Javert, C. T.\n          \n          The spread of benign and malignant endometrium in the lymphatic system with a note on coexisting vascular involvement.\n          Am J Obstet Gynecol\n          1952. 64:780\u2013806."},{"key":"i1543-2165-129-5-e117-b9","series-title":"Arch Pathol","first-page":"698","article-title":"Neoplasms of the subcoelomic mesenchyme.","volume":"59","author":"Ober, W. B.","year":"1955","unstructured":"Ober, W. B. and M. B.Black. Neoplasms of the subcoelomic mesenchyme.Arch Pathol1955. 59:698\u2013705."},{"key":"i1543-2165-129-5-e117-b10","series-title":"J Pathol","first-page":"301","article-title":"Benign lymph node inclusions.","volume":"173","author":"Rutty, G. N.","year":"1994","unstructured":"Rutty, G. N.\n          \n          Benign lymph node inclusions.\n          J Pathol\n          1994. 173:301\u2013302."},{"key":"i1543-2165-129-5-e117-b11","series-title":"Am J Clin Pathol","first-page":"741","article-title":"Mesothelial cell inclusions in mediastinal lymph nodes mimicking metastatic carcinoma.","volume":"93","author":"Brooks, J. S. J.","year":"1990","unstructured":"Brooks, J. S. J., V. A.LiVolsi, and G. G.Pietra. Mesothelial cell inclusions in mediastinal lymph nodes mimicking metastatic carcinoma.Am J Clin Pathol1990. 93:741\u2013748."},{"key":"i1543-2165-129-5-e117-b12","series-title":"Am J Surg Pathol","first-page":"1264","article-title":"Benign mesothelial cells in mediastinal lymph nodes.","volume":"23","author":"Parkash, V.","year":"1999","unstructured":"Parkash, V., M.Vidwans, and D.Carter. Benign mesothelial cells in mediastinal lymph nodes.Am J Surg Pathol1999. 23:1264\u20131269."},{"key":"i1543-2165-129-5-e117-b13","series-title":"Pathol Res Pract","first-page":"991","article-title":"Frequency and histogenesis of pelvic retroperitoneal lymph node inclusions of the female genital tract: an immunohistochemical study of 34 cases.","volume":"191","author":"Horn, L. C.","year":"1995","unstructured":"Horn, L. C. and K.Bilek. Frequency and histogenesis of pelvic retroperitoneal lymph node inclusions of the female genital tract: an immunohistochemical study of 34 cases.Pathol Res Pract1995. 191:991\u2013996."},{"key":"i1543-2165-129-5-e117-b14","series-title":"Arch Pathol Lab Med","first-page":"841","article-title":"Benign m\u00fcllerian lymph node inclusions: an unusual case with implications for pathogenesis and review of the literature.","volume":"119","author":"Henley, J. D.","year":"1995","unstructured":"Henley, J. D., H. B.Michael, G. W.English, and L. M.Roth. Benign m\u00fcllerian lymph node inclusions: an unusual case with implications for pathogenesis and review of the literature.Arch Pathol Lab Med1995. 119:841\u2013844."}],"container-title":["Archives of Pathology &amp; Laboratory Medicine"],"original-title":[],"link":[{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/129\/5\/article-pe117.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/129\/5\/e117\/2756542\/1543-2165(2005)129_e117_edopln_2_0_co_2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/129\/5\/article-pe117.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/129\/5\/article-pe117.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T01:12:46Z","timestamp":1770772366000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/129\/5\/article-pe117.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,5]]},"references-count":28,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.5858\/2005-129-e117-edopln","relation":{},"ISSN":["1543-2165","0003-9985"],"issn-type":[{"value":"1543-2165","type":"electronic"},{"value":"0003-9985","type":"print"}],"subject":[],"published":{"date-parts":[[2005,5]]}}}