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Necrobiotic granulomas of the urogenital system.

Recently, Akosa and Boret' described the condition of four patients who complained of menorrhagia which was treated by laser ablation of the endometrium. Treatment failed in these patients and hysterectomy was performed. Necrotising histiocytic granulomas were found in the endometria of all the four cases. We have recently investigated nine similar hysterectomy specimens which were subjected to laser ablation of the endometrium (unpublished data, 1994, Aqel et al). We found scattered histiocytes and/or multinucleated giant cells in the endometria of eight ofthe nine cases. Some of the histiocytes formed necrotising granulomas. In all cases histiocytes showed intracytoplasmic black and golden-brown pigment; in addition, residual endometria contained variable quantities of haemosiderin (Perl's positive) which suggested past injury and haemorrhage in the basal layer of the endometrium. We have also recently examined a urinary bladder biopsy specimen which was removed three months after diathermy resection of a transitional cell carcinoma. This biopsy speci-