Suh K S, Silverberg S G
Department of Pathology, George Washington University Medical Center, Washington, D.C. 20037.
Int J Gynecol Pathol. 1990;9(2):122-8. doi: 10.1097/00004347-199004000-00003.
Eleven cases of tubal metaplasia of the uterine cervix are presented. These are characterized histologically by architecturally normal endocervical glands containing ciliated or clear cells, nonciliated cells, and intercalary or peg cells, resembling normal tubal mucosa. Transitions from normal to ciliated epithelium within a single gland are frequently seen. Eight of these cases involved endocervical glands near the squamocolumnar junction, and six showed tubal metaplasia along the overlying surface epithelium. Superficial and (in one case) deep endocervical glands were involved. No correlation was found between the presence of tubal metaplasia and the degree of inflammation of the cervix or the presence or extent of squamous metaplasia. Immunohistochemically, the epithelium of tubal metaplasia was negative for carcinoembryonic antigen in five cases studied. In situ squamous carcinoma and a variety of benign glandular lesions, such as microglandular hyperplasia, mesonephric remnants, and endometriosis, were concurrently identified. Two cases also accompanied tubal metaplasia in proliferative and hyperplastic endometria, and tubal metaplasia was seen in the lower uterine segment in five cases. We emphasize that, as with other types of metaplasia, the main significance of recognizing this lesion in the cervix is in not confusing it with early endocervical glandular neoplasia.
本文报告了11例子宫颈管化生病例。这些病例在组织学上的特征为，宫颈管内腺体结构正常，含有纤毛细胞或透明细胞、非纤毛细胞以及闰细胞或钉状细胞，类似于正常输卵管黏膜。在单个腺体内常可见从正常上皮向纤毛上皮的转变。其中8例累及鳞柱交界附近的宫颈管腺体，6例在上覆表面上皮出现输卵管化生。累及了浅表及（1例）深部宫颈管腺体。未发现输卵管化生的存在与宫颈炎症程度或鳞状化生的存在及范围之间存在相关性。免疫组织化学检查显示，在5例研究病例中，输卵管化生上皮癌胚抗原呈阴性。同时还发现了原位鳞状癌以及多种良性腺体病变，如微小腺体增生、中肾残余和子宫内膜异位症。2例还伴有增殖期和增生期子宫内膜的输卵管化生，5例在子宫下段可见输卵管化生。我们强调，与其他类型的化生一样，识别宫颈的这种病变的主要意义在于不将其与早期宫颈管腺体肿瘤相混淆。
