Gupta Ruchika, Bansal Bhavna, Singh Sompal, Yadav Indra, Gupta Kusum, Kudesia Madhur
Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110076, India.
Cases J. 2009 Dec 11;2:9306. doi: 10.1186/1757-1626-2-9306.
Lichen planus is an immune mediated inflammatory lesion involving skin and mucosal sites including oral mucosa, vulva and rarely vagina. Lichen planus occurring at mucosal sites has been shown to be associated with squamous cell carcinoma in a proportion of cases. To the best of our knowledge, no case of lichen planus of uterine cervix has been reported in the available literature.
A 45-year-old female underwent vaginal hysterectomy for uterine prolapse. The resected specimen showed a bluish-colored area in the non-dependent part of the ectocervix. Microscopic sections from this area showed dense lymphocytic infiltrate at the junction of mucosa and submucosa causing disruption of the basal cell layer. On immunohistochemical examination there was predominance of CD8+ T lymphocytes at the junction with scattered CD4+ T lymphocytes, characteristic of lichen planus. Based on the history and negative serum antibody titers, other differential diagnoses including lupus erythematosus and drug reaction were excluded. The patient did not have any cutaneous or oral lesions of lichen planus.
Lichen planus of uterine cervix is a hitherto unreported entity, and is worth studying considering the premalignant potential of lichen planus at other mucosal sites.
扁平苔藓是一种免疫介导的炎症性病变,累及皮肤和黏膜部位,包括口腔黏膜、外阴,很少累及阴道。已证实,部分发生于黏膜部位的扁平苔藓与鳞状细胞癌有关。据我们所知,现有文献中尚未报道过子宫颈扁平苔藓病例。
一名45岁女性因子宫脱垂接受了阴道子宫切除术。切除标本的子宫颈外口非下垂部位可见一个蓝色区域。该区域的显微镜切片显示,黏膜与黏膜下层交界处有密集的淋巴细胞浸润,导致基底细胞层破坏。免疫组化检查显示,交界处以CD8 + T淋巴细胞为主,散在分布着CD4 + T淋巴细胞,这是扁平苔藓的特征。根据病史及血清抗体滴度阴性,排除了包括红斑狼疮和药物反应在内的其他鉴别诊断。该患者没有任何皮肤或口腔扁平苔藓病变。
子宫颈扁平苔藓是一种迄今尚未报道的疾病,鉴于扁平苔藓在其他黏膜部位具有恶变潜能,值得进一步研究。