Zámečník Michal, Hoštáková Denisa
Medicyt s. r. o., Laboratory of Surgical Pathology, Trenčin, Slovak Republic.
Cesk Patol. 2013 Jun;49(3):134-6.
A rare case of endometriosis occurring in paratesticular mesothelial cyst is presented. It was found in a 7 mm mesothelial inclusion cyst of tunica vaginalis in a 46-years-old old man who underwent a radical orchiectomy for seminoma. It showed a typical histologic pattern with endometrioid cylindrical epithelium and cellular stroma. The lesion was immunohistochemically positive for estrogen receptors and progesterone receptors, in contrast with the adjacent mesothelium. However, rare endometrioid epithelial cells expressed mesothelial markers calretinin and cytokeratin 5/6. This immunohistochemical overlap with mesothelium and morphological transition between endometrioid epithelium and mesothelium favor metaplastic pathogenesis of the lesion. In differential diagnosis, it is important to distinguish paratesticular endometriosis from tissue of teratoma (especially when a germ cell tumor is present in the testis, as was seen in this case).
本文报告了一例罕见的发生于睾丸旁间皮囊肿的子宫内膜异位症病例。该病例为一名46岁男性，因精原细胞瘤接受根治性睾丸切除术后，在其鞘膜的一个7mm间皮包涵囊肿中发现了该病。它呈现出典型的组织学模式，具有子宫内膜样柱状上皮和细胞性间质。与相邻的间皮不同，该病变的雌激素受体和孕激素受体免疫组化呈阳性。然而，罕见的子宫内膜样上皮细胞表达间皮标志物钙视网膜蛋白和细胞角蛋白5/6。这种与间皮的免疫组化重叠以及子宫内膜样上皮和间皮之间的形态学转变支持该病变的化生发病机制。在鉴别诊断中，将睾丸旁子宫内膜异位症与畸胎瘤组织区分开来很重要（特别是当睾丸中存在生殖细胞肿瘤时，本病例即如此）。
