高分化乳头状间皮瘤合并盆腔子宫内膜异位症一例并文献复习

doi:10.12280/gjfckx.20210969

摘要/Abstract

摘要：

高分化乳头状间皮瘤是一种罕见的疾病,通常在其他疾病的手术中意外发现。其病因未明,发病原因可能与子宫内膜异位症有关。由于其发病率低,妇科医生普遍对其认识不足,易造成漏诊、误诊。报告1例高分化乳头状间皮瘤患者的病例资料,该患者因子宫肌瘤收入院行腹腔镜手术治疗,术中探查发现盆腔脏层腹膜及子宫后壁浆膜散在片状乳白色粟粒样病灶,直径0.2~0.5 cm,其旁可见盆腔腹膜型子宫内膜异位病灶,术中行病灶活检术,经活检病理、免疫组织化学及分子检测诊断为高分化乳头状间皮瘤。通过文献复习该病的发病机制、临床表现、诊断、鉴别诊断及治疗,总结该病例的诊疗经验。

关键词: 间皮瘤, 腹膜, 子宫内膜异位症, 诊断,鉴别, 病例报告

Abstract:

Well-differentiated papillary mesothelioma is a rare disease, and it is often found accidentally during surgery for other diseases. Its etiology is unknown, and its cause may be related to endometriosis. However, due to its low incidence, gynecologists generally do not know enough about it, which is easy to cause missed or misdiagnosed. This paper reported a case of well-differentiated papillary mesothelioma. The patient was admitted to the hospital for laparoscopic surgery for uterine fibroids. Intraoperative exploration revealed scattered patchy milky white corn-like lesions of 0.2-0.5 cm in diameter in the pelvic peritoneum and the posterior uterine wall serous membrane, with pelvic peritoneal endometriosis lesions next to them. Intraoperative biopsy of the lesion was performed, and well-differentiated papillary mesothelioma was diagnosed by histological pathology, immunohistochemistry and molecular detection. The pathogenesis, clinical manifestations, diagnosis, differential diagnosis and treatment of this disease were reviewed through the literature, and the diagnosis and treatment experience of this case was summarized.

Key words: Mesothelioma, Peritoneum, Endometriosis, Diagnosis,differential, Case reports

许阡, 柳鑫, 王金娟, 徐飞. 高分化乳头状间皮瘤合并盆腔子宫内膜异位症一例并文献复习[J]. 国际妇产科学杂志, 2022, 49(3): 313-316.

XU Qian, LIU Xin, WANG Jin-juan, XU Fei. Well-Differentiated Papillary Mesothelioma Combined with Pelvic Endometriosis：A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2022, 49(3): 313-316.

图/表 3

图1 腹腔镜探查术中所见注：盆腔脏层腹膜及子宫后壁浆膜散在片状乳白色粟粒样病灶,直径0.2~0.5 cm,表面不光滑（左箭头）,其旁可见盆腔腹膜型子宫内膜异位病灶（右箭头）。

图2 术后病理图（HE×10）注：乳头状肿瘤样组织,其内细胞呈巢片状,腺管样及条索状排列。

图3 高分化乳头状间皮瘤免疫组织化学图（EnVision法×20）

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