Department of Pathology, AIIMS, New Delhi, India.
J Clin Pathol. 2010 May;63(5):452-4. doi: 10.1136/jcp.2009.073312. Epub 2010 Mar 18.
A 27-year-old nulliparous woman presented with large finger-like projections protruding from her vagina. Intraoperatively there were deposits in the pouch of Douglas. Clinical presentation and history of vaginal bleeding suggested malignancy. Histopathology of both the vaginal and pouch of Douglas masses showed endometrial glands and stroma. There was no architectural complexity or cytological atypia of glands or stroma. Immunohistochemistry for oestrogen receptor, progesterone receptor and CD10 was positive. Based on morphological and immunohistochemical findings, multifocal polypoid endometriosis was diagnosed; this is a recently described entity having a clinical presentation and age range completely different from conventional or non-polypoid endometriosis. Although an association between tamoxifen use, unopposed oestrogen therapy and polypoid endometriosis has been suggested, the patient had no history of tamoxifen or oestrogen intake. Polypoid endometriosis should be part of the differential diagnosis in young women presenting with vaginal growth.
一位 27 岁的未婚女性，出现从阴道突出的类似手指的大突起。术中在道格拉斯袋中有沉积物。阴道出血的临床表现和病史提示恶性肿瘤。阴道和道格拉斯袋肿块的组织病理学显示子宫内膜腺体和基质。腺体和基质无结构复杂性或细胞学异型性。雌激素受体、孕激素受体和 CD10 的免疫组化均为阳性。基于形态学和免疫组化发现，诊断为多灶性息肉状子宫内膜异位症；这是一种最近描述的实体，其临床表现和年龄范围与传统或非息肉状子宫内膜异位症完全不同。尽管已经提出了他莫昔芬使用、雌激素治疗和息肉状子宫内膜异位症之间的关联，但该患者没有他莫昔芬或雌激素摄入的病史。息肉状子宫内膜异位症应成为年轻女性出现阴道生长的鉴别诊断的一部分。
