Suster S, Moran C A
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.
Am J Gastroenterol. 1990 Jul;85(7):841-5.
A clinicopathologic and immunohistochemical study of six cases of deciduosis of the appendix is presented. The patients were pregnant women aged 18-40 years. In four cases, the patients presented with signs and symptoms of acute appendicitis during their 26th to 31st week of pregnancy; in the other two, the lesions were discovered incidentally in appendectomy specimens obtained during cesarean section and tubal ligation at term. Histologically, the lesions were characterized by the presence of multiple, irregularly distributed submesothelial deposits of decidualized cells in the serosa of the appendix, without any associated evidence of endometriosis. By immunohistochemistry, the decidualized cells strongly labelled with vimentin antibodies, consistent with their stromal origin. In two cases, coexpression of vimentin and desmin intermediate filaments was observed, suggestive of myoid differentiation. The possible relationship of the lesions with the development of symptoms of peritoneal irritation in these patients is discussed along with a review of the literature on the abdominal complications of ectopic decidua.
本文报道了6例阑尾蜕膜样变的临床病理及免疫组化研究。患者为18 - 40岁的孕妇。4例患者在妊娠26至31周时出现急性阑尾炎的症状和体征；另外2例是在足月剖宫产和输卵管结扎时切除的阑尾标本中偶然发现病变。组织学上，病变的特征是阑尾浆膜下存在多个分布不规则的蜕膜样细胞亚间皮沉积，无任何相关子宫内膜异位症证据。免疫组化显示，蜕膜样细胞被波形蛋白抗体强烈标记，与其间质来源一致。2例观察到波形蛋白和结蛋白中间丝的共表达，提示肌样分化。本文讨论了这些病变与患者腹膜刺激症状发展之间的可能关系，并回顾了异位蜕膜腹部并发症的相关文献。
