摘要
目的:探讨子宫内膜和卵巢原发性双癌合并子宫颈内膜异位症伴不典型增生的临床病理特征及鉴别诊断。方法:分析1例子宫内膜和卵巢原发性双癌合并子宫颈内膜异位症伴不典型增生的组织病理学、免疫表型资料并复习文献。结果:患者左侧附件可见5cm×4cm×3cm大囊状肿物一个,囊内壁附着约直径3cm大实性结节;子宫腔宫底可见3cm×2.5cm×1cm大菜花状肿物;镜下两者均为高分化子宫内膜样腺癌伴左侧卵巢子宫内膜异位;同时,子宫颈局部表面见灰褐色出血点,镜下示子宫颈子宫内膜异位伴腺上皮不典型增生。3处肿瘤细胞ER-α、ER-β、PTEN及Bcl-2表达一致。结论:子宫内膜和卵巢原发性双癌合并子宫颈内膜异位症伴不典型增生多发生于绝经前女性,少见肿瘤,一般发现早,预后较好。子宫内膜异位与此类病例发病有一定关系,取材时应考虑到多部位子宫内膜异位的可能,尽量减少漏诊率。
Objective：To investigate the clinicolpathologieal features and differential diagnosis of synchronous pri- mary cancer of endometrium and cervical endometriosis with atypical hyperplasia. Methods： We analyzed the histo- pathology, immune phenotype of synchronous primary cancer of endometrium and ovary coexisting with endometriosls and atypical hyperplasia and with literature review. Results： Grossly, patient left adnexal tumor was cystic - solid, size about 5cm × 4cm × 3cm; inner wall attached about 3cm big solid nodules. Uterine angle was large cauliflower shape, the mass was about 3em × 2.5cm × 1cm. The two tumors were both well - differentiated endometrial adenocar- cinoma with the left ovarian endometriosis microscopically. At the same time, the cervical surface showed beige and cervical endometriosis with glandular epithelium atypical hyperplasia. Three sites of the tumor were positive for ER - α, PR detection, and negative for ER -β, Be1 - 2. Conclusion： Synchronous primary cancer of endometrium and cervical endometriosis with atypical hyperplasia is often detedcted in premenopansal women. The prognosis is good if it was early diagnosed. Endometriosis is related with this disease to some extent. In order to reduce the omission diag- nostic rate, endometriosis of multiple sites should be paid more attention during pathologic specimen cutting.
出处
《现代肿瘤医学》
CAS
2012年第7期1423-1426,共4页
Journal of Modern Oncology
基金
广州医学院第三附属医学青年启动基金项目(编号:2010Y08)
