Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan.
Pathol Res Pract. 2012 Jan 15;208(1):59-61. doi: 10.1016/j.prp.2011.10.007. Epub 2011 Nov 21.
A rare case of paratesticular endometriosis in a 69-year-old male with prostatic carcinoma, who had a history of 9-year hormonal therapy, is presented. The lesion was a multilocular cyst, 5.2 cm × 3.1 cm × 3.0 cm in size, in the left paratestis. The cysts were lined by a single layer of cuboidal cells. A small number of glands were scattered in the underling stroma composed of closely packed small round or ovoid cells with scant cytoplasm resembling endometrial stromal cells, and abundant capillaries. Hemosiderin deposits were observed. Immunohistochemically, the lining cells of the cysts and glands were positive for CAM5.2, vimentin and calretinin, and were negative for CD10, estrogen and progesterone-receptors, indicating mesothelial profiles. The stromal cells expressed vimentin, estrogen- and progesterone-receptors and CD10. The findings indicated stromal endometriosis associated with the tunica vaginalis. Mullerian or endometriotic metaplasia and stromal cell hyperplasia under the influence of prolonged estrogen therapy may be the mechanism of this lesion.
现报道 1 例罕见的 69 岁男性前列腺癌患者发生的副睾子宫内膜异位症，该患者有 9 年激素治疗史。病变为 5.2cm×3.1cm×3.0cm 的多房性囊肿，位于左侧副睾。囊肿由单层立方细胞衬里。少量腺体散在于由紧密排列的小圆或卵圆形细胞组成的固有基质中，细胞胞质稀少，类似于子宫内膜基质细胞，且富含毛细血管。可见含铁血黄素沉积。免疫组化染色显示，囊肿和腺体的衬里细胞表达 CAM5.2、波形蛋白和钙视网膜蛋白，而不表达 CD10、雌激素和孕激素受体，提示间皮表型。基质细胞表达波形蛋白、雌激素和孕激素受体以及 CD10。这些发现表明与鞘膜有关的基质子宫内膜异位症。在长期雌激素治疗的影响下，米勒管或子宫内膜异位症化生以及基质细胞增生可能是该病变的机制。
