炎性泄殖腔源性息肉临床病理学分析  

Clinicopathological features of Inflammatory cloacogenic polyp

作　　者：蒋汉文 苏曙光 万里燕 郭明星 赖肖芬 李艳 郭雄波 JIANG Han-wen;SU Shu-guang;WAN Li-yan;GUO Ming-xing;LAI Xiao-fen;LI Yan;GUO Xiong-bo(Department of Pathology,Guangzhou Panyu Maternal and Child Health Hospital,Guangzhou 511402,China;Department of Pathology,Panyu Central Hospital,Guangzhou 511400,China;Department of Gastroiwtestinal Surgery the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 511447,China)

机构地区：[1]广州市番禺区妇幼保健院病理科,广州511402 [2]广州市番禺区中心医院病理科,广州1511400 [3]广州医科大学附属第二医院胃肠外科,广州511447

出　　处：《诊断病理学杂志》2022年第10期952-955,共4页Chinese Journal of Diagnostic Pathology

基　　金：广州市番禺区科技计划项目(2021-Z04-024);广州市卫健委医学科研项目(20221A010050)。

摘　　要：目的 探讨炎性泄殖腔源性息肉(ICP)的临床表现及病理学特征。方法 回顾性分析广州市番禺区妇幼保健院病理科、广州市番禺区中心医院病理科及广州医科大学附属第二医院胃肠外科于2014-01—2021-12收集的7例诊断为ICP的临床资料、病理石蜡切片、免疫组化切片并复习相关文献。结果 7例ICP患者,男性2例,女性5例,平均年龄59岁,临床主要表现为肛管肿物,可伴反复出血。镜下见由直肠黏膜的柱状上皮、肛管移行带(ATZ)上皮与肛管鳞状上皮被覆,常伴柱状上皮糜烂、脱落。直肠黏膜腺体形态多样,呈拉长、扭曲、分支或轻度锯齿状,黏膜表面可见形态复杂的绒毛状结构。位于黏膜固有层及黏膜肌层的平滑肌及纤维组织明显增生,层厚增加,平滑肌排列紊乱,可使腺体隐窝内陷于黏膜肌层中形成异位腺体。免疫组化Desmin显示黏膜层隐窝间的平滑肌组织呈不连续且无多级分支结构,并指向黏膜表面。结论 ICP是一种少见的良性肛管病变,属于黏膜脱垂相关性炎症性息肉中一个亚型,确诊主要依赖发病部位及病理学形态。需要与各种发生于肛管上皮移行区的病变相鉴别,尤其是肛管腺癌。Objective To investigate the clinical and pathological features of inflammatory cloacal polyp ICP. MethodsThe clinical data, pathological paraffin sections and immunohistochemical sections of 7 cases diagnosed as ICP collected in the Department of Pathology, the three hospitals from January 2014 to December 2021 were analyzed retrospectively, and the relevant literature was reviewed. Results There were 7 ICP patients, 2 males and 5 females, with an average age of 59 years. The main clinical manifestation was an anal mass, which could be accompanied by repeated bleeding. Microscopically, it was covered by columnar epithelium of rectal mucosa, anal transitional zone(ATZ) epithelium and anal squamous epithelium, often accompanied by erosion and shedding of the columnar epithelium. The rectal mucosal glands had various shapes, which were elongated, twisted, branched or slightly serrated. Complex villous structures were seen on the mucosal surface. The smooth muscle and fibrous tissue located in the mucosa proper layer and the mucosa muscle layer were obviously proliferated, the layer thickness was increased, and the smooth muscle arrangement was disordered, which could cause the gland crypt to be trapped in the mucosa muscle layer to form ectopic glands. Immunohistochemical staining showed that the smooth muscle tissue between the crypts of the mucosal layer was discontinuous and had no multi-level branching structure, and pointed to the mucosal surface. Conclusion ICP is a rare benign anal lesion, which belongs to a subtype of mucosal prolapse associated inflammatory polyps. The diagnosis mainly depends on the location and pathological morphology. It is necessary to distinguish anal epithelial lesions from anal transitional epithelial lesions, especially anal adenocarcinoma.

关 键 词：肛管 炎性泄殖腔源性息肉 黏膜脱垂相关性炎症性息肉 

分 类 号：R73[医药卫生—肿瘤]