Department of Digestive and Endocrine Surgery, University Hospital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, Paris, France.
Diagn Pathol. 2012 Jun 7;7:62. doi: 10.1186/1746-1596-7-62.
Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. We report a case of a woman who presented an ileocecal intussusception due to a cecal endometriosis. The patient gave two months history of chronic periombilical pain requiring regular hospital admission and analgesia. The symptoms were not related to menses. A laparotomy was performed and revealed an ileocolic intussusception. The abdominal exploration did not find any endometriosis lesion. Ileocaecal resection was performed. Microscopic examination showed a cystic component, lined by a regular cylindric epithelium. Foci of endometrial tissue were observed in the cecal subserosa and muscularis mucosal, with irregular endometrial glands lined by cylindric epithelium without atypia immunostained with CK7, and characteristic endometrial stroma immunostained with CD10. Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. Diagnose of etiology remains challenging due to the absence of clinical and radiological specific characteristics.
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2975867306869166.
盲肠子宫内膜异位症和回盲肠肠套叠极为罕见。我们报告一例盲肠子宫内膜异位症引起的回盲肠肠套叠病例。该患者表现为慢性脐周疼痛,需定期住院和使用镇痛药,病史长达 2 个月。症状与月经无关。行剖腹探查术,发现回盲肠肠套叠。腹部探查未发现任何子宫内膜异位症病变。行回盲部切除术。显微镜检查显示囊状成分,由规则的柱状上皮衬里。盲肠浆膜下和黏膜固有肌层可见子宫内膜组织灶,有非典型性的 CK7 免疫染色的柱状上皮衬里的不规则子宫内膜腺体,和特征性的 CD10 免疫染色的子宫内膜间质。盲肠子宫内膜异位症和回盲肠肠套叠极为罕见。由于缺乏临床和影像学的特异性特征,病因诊断仍然具有挑战性。