Baird David, Klepeiss Stacy, Wehler Amanda, Harkins Gerald, Anderson Bryan
Penn State College of Medicine, Hershey, PA, USA.
Skinmed. 2012 Jul-Aug;10(4):248-50.
A 39-year-old woman presented for evaluation of a tender nodule on the umbilicus that had been present for 6 months. She stated that it had slowly been increasing in size and would occasionally open up and crust over with dried blood. Physical examination revealed a 4-mm firm, tender, brown papule in the umbilicus (Figure 1). She had a history of chronic pelvic pain and exploratory laparoscopy for endometriosis 10 years prior, at which time the diagnosis ofa bicornuate uterus was made. Subsequently, hysterectomy was performed (Figure 2) at which time the entire umbilical lesion was excised. Histopathology revealed branching tubular glands in the dermis lined by stratified columnar epithelium, surrounded by small cells with scant cytoplasm, characteristic of proliferative-phase endometrial stroma (Figure 3 and Figure 4). These findings were consistent with a diagnosis of umbilical endometriosis (Villar's nodule). Subsequent examination revealed no evidence of recurrence.
一名39岁女性因脐部出现一个已存在6个月的压痛性小结节前来评估。她说结节大小在缓慢增大，偶尔会破溃并结有干血痂。体格检查发现脐部有一个4毫米大小、质地坚硬、有压痛的褐色丘疹（图1）。她有慢性盆腔疼痛病史，10年前因子宫内膜异位症接受了 exploratory laparoscopy（此处“exploratory laparoscopy”可能有误，推测可能是“腹腔镜探查术”），当时诊断为双角子宫。随后进行了子宫切除术（图2），此时整个脐部病变被切除。组织病理学显示真皮内有分支管状腺体，内衬复层柱状上皮，周围是细胞质稀少的小细胞，具有增殖期子宫内膜间质的特征（图3和图4）。这些发现符合脐部子宫内膜异位症（维拉结节）的诊断。后续检查未发现复发迹象。
