Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Diagn Pathol. 2006 May 19;1:8. doi: 10.1186/1746-1596-1-8.
Ichthyosis uteri is an exceedingly rare condition in which the entire surface of the endometrium is replaced by stratified squamous epithelium. Originally described as an endometrial response to iatrogenically-introduced caustic substances, similar changes have since been described in association with a variety of inflammatory conditions of the endometrium. We describe herein a heretofore undescribed example of a moderately differentiated squamous cell carcinoma of the uterine cervix associated with extensive ichthyosis uteri-like changes of the entire adjacent endometrium. Additionally, the squamous epithelium of the latter also showed multifocal changes diagnostic of a low-grade squamous intraepithelial lesion. The potential genesis of this composite of findings is discussed, as is the neoplastic potential of ichthyosis uteri. It is concluded that a squamous cell carcinoma of the cervix extended proximally into the endometrium, and that there was a colonization of a pre-existing ichthyosis uteri by associated human papillomavirus. The possibility of significant cervical pathology should be considered when plaques of squamous epithelium with low grade dysplastic changes are identified in an endometrial biopsy or curettage.
子宫角化病是一种极其罕见的疾病，其整个子宫内膜表面被复层鳞状上皮取代。最初被描述为子宫内膜对医源性腐蚀性物质的反应，此后类似的改变已在与子宫内膜的各种炎症状态相关的情况下描述。本文描述了一种以前未描述的宫颈中度分化鳞状细胞癌与广泛的子宫角化病样改变相关的病例，这些改变累及整个邻近的子宫内膜。此外，后者的鳞状上皮还显示出多灶性改变，诊断为低度鳞状上皮内病变。讨论了这些发现的潜在发生机制，以及子宫角化病的肿瘤发生潜能。结论是宫颈的鳞状细胞癌向子宫内膜近端延伸，并存在与人乳头瘤病毒相关的先前存在的子宫角化病的定植。当在子宫内膜活检或刮宫中发现具有低度异型性改变的鳞状上皮斑块时，应考虑存在显著的宫颈病变的可能性。
