Mudhar H S, Smith J H, Tidy J
Department of Histopathology, Northern General Hospital, Herries Road, Sheffield S5 7AU, United Kingdom.
Int J Gynecol Pathol. 2001 Apr;20(2):204-9. doi: 10.1097/00004347-200104000-00016.
A 1 cm polypoid lesion was encountered on the posterior vaginal wall in a 56-year-old woman with no history of diethylstilbestrol exposure that on microscopic examination was a moderately differentiated adenocarcinoma of intestinal type. The tumor was cytokeratin 20 and carcinoembryonic antigen positive and negative for cytokeratin 7. Mucin histochemistry demonstrated the presence of o-acetylated sialomucin, a specific marker of large intestinal differentiation. The initial interpretation favored a metastasis from a colonic adenocarcinoma, but clinical investigations showed no evidence of a primary gastrointestinal lesion. The morphology, histochemical, and differential cytokeratin profile led to the lesion being reinterpreted as a primary intestinal-type adenocarcinoma of the vagina arising from a tubular adenoma. Although a very rare tumor, awareness of this lesion is important as it must be distinguished from metastatic adenocarcinomas from other sites.
一名56岁女性，无己烯雌酚暴露史，阴道后壁发现一个1厘米的息肉样病变，显微镜检查显示为中度分化的肠型腺癌。肿瘤细胞角蛋白20和癌胚抗原呈阳性，细胞角蛋白7呈阴性。黏液组织化学显示存在O-乙酰化唾液黏蛋白，这是大肠分化的特异性标志物。最初的诊断倾向于结肠腺癌转移，但临床检查未发现原发性胃肠道病变的证据。根据形态学、组织化学和细胞角蛋白差异谱，该病变被重新解释为由管状腺瘤引起的原发性阴道肠型腺癌。尽管这是一种非常罕见的肿瘤，但认识到这种病变很重要，因为它必须与其他部位的转移性腺癌相鉴别。
