Scurry J, Planner R, Grant P
Department of Anatomical Pathology, Mercy Maternity Hospital, East Melbourne, Australia.
Gynecol Oncol. 1991 May;41(2):172-7. doi: 10.1016/0090-8258(91)90280-i.
Two unusual cases of vaginal adenosis in non-diethylstilbestrol (DES)-exposed patients are presented. These cases created an initial difficulty in histological classification and exclusion of the diagnosis of adenocarcinoma. The first case presented a problem of atypical columnar epithelium with simple gland architecture, while the second showed a pseudoinfiltrative pattern of small glands, but without cytological atypia. A diagnosis of glandular dysplasia (atypical columnar epithelium) was finally made in the first case and vaginal adenosis with unusual architectural features in the second. The first patient was treated by excision and the second expectantly. Subsquently, neither patient has developed carcinoma. The spectrum of glandular changes in vaginal adenosis appears analogous to that of the cervix. Until the natural history of sufficient numbers of these variants of vaginal adenosis have been studied, the analogous cervical condition may serve as a guide to prognosis. The diagnosis of invasive adenocarcinoma should be made cautiously unless there are both architectural and cytological features of malignancy.
本文报告了两例未接触己烯雌酚（DES）的患者发生阴道腺病的罕见病例。这些病例在组织学分类和排除腺癌诊断方面最初存在困难。第一例表现为具有简单腺结构的非典型柱状上皮问题，而第二例显示小腺体的假浸润模式，但无细胞学异型性。第一例最终诊断为腺发育异常（非典型柱状上皮），第二例诊断为具有不寻常结构特征的阴道腺病。第一例患者接受了切除术，第二例则采取观察等待。随后，两名患者均未发生癌变。阴道腺病的腺体变化谱似乎与宫颈的相似。在对足够数量的这些阴道腺病变体的自然史进行研究之前，类似的宫颈情况可作为预后的指导。除非存在恶性肿瘤的结构和细胞学特征，否则应谨慎做出浸润性腺癌的诊断。
