不同部位息肉样子宫内膜异位症临床和病理特征11例分析  

Clinical and pathological features of 11 cases of polypoid endometriosis in different locations

作　　者：宋玉芳 韩璐 王亚萍 张丽芝[3] 李贞梅 

机构地区：[1]大连医科大学附属大连市妇产医院暨大连市妇幼保健院妇科,辽宁大连116033 [2]大连医科大学附属大连市妇产医院暨大连市妇幼保健院病理科,辽宁大连116033 [3]大连医科大学附属第一医院病理科,辽宁大连116011

出　　处：《中国实用妇科与产科杂志》2017年第11期1193-1198,共6页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨息肉样子宫内膜异位症(PEM)的临床和病理特征、诊治方法及预后。方法回顾性分析2012年7月至2016年4月于大连医科大学附属大连市妇产医院暨大连市妇幼保健院及大连医科大学附属第一医院收治的11例PEM患者的临床资料,总结其临床和病理特征、诊治方法及预后情况。结果患者发病年龄23~51(41.20±8.97)岁。主要临床表现以病变部位包块、肿瘤引起症状体征及压迫症状体征为主,如盆腔包块、腹股沟区包块、阴道流血、肾积水、腰部疼痛、膀胱占位性病变等,部分临床表现类似恶性肿瘤。大体特征为囊肿内或外生性息肉样肿块;镜下特征具有普通子宫内膜异位症(EM)的病理学特点,病变组织均由子宫内膜样腺体及间质成分构成,但比普通EM更具多样性;免疫组化PEM组织内雌激素受体(ER)、孕激素受体(PR)、CD10、波形蛋白(Vimentin)表达阳性。11例患者均采取手术治疗。10例获得随访,中位随访时间为21个月(9~54个月),1例复发,行二次肿物切除术,10例均存活良好。结论 PEM是EM的一种罕见亚型,临床表现与生长部位相关,呈多样性,诊断主要依靠病理学检查,治疗多以手术为主,预后良好。Objective To study the clinical and pathological characteristics, diagnosis, treatment and prognosis of the polypoid endometriosis （PEM）. Methods A retrospective analysis was performed in 11 cases of PEM who were admitted to Dalian Obstetrics and Gynecology Hospital, Affiliated Hospital of Dalian Medical University and the First Affiliated Hospital of Dalian Medical University from July 2012 to April 2016, related literature was analyzed, and the clinical and pathological characteristics, diagnosis, treatment and prognosis of PEM were summarized. Results Totally 11 patients, the mean age was （41.20± 8.97）years （ranging 23-51 years）.The main clinical manifestations were the symptoms and signs caused by mass or tumor of the lesions, such as pelvic mass, inguinal mass, vaginal bleeding, hydronephrosis, waist pain, bladder mass and so on, and some manifestations were similar to malignant tumors. It was generally characterized by a cyst inside or pedunculated polyp-like masses.Endoscopic characteristics were those of ordinary endometriosis （EM）pathology, and the lesions were composed of endometrial glandular and stromal components, but were more various than the ordinary EM.The expressions of immunohistochemistry of ER, PR, CD10 and Vimentin were positive in the PEM tissues. All 11 patients underwent surgery, and 10 cases were followed up, median follow-up period being 21 months （9-54 months ） .There was a case of recurrence, who received secondary tumor resection.All of the 10 cases survived well. Conclusion PEM is a rare subtype of EM, and its clinical manifestations are associated with the growth sites, showing diversity.The diagnosis of PEM is mainly based on oathology, the treatment is mainly by surgery,and its prognosis is good.

关 键 词：子宫内膜异位症 息肉样 临床特征 病理特征 

分 类 号：R711.71[医药卫生—妇产科学]