Department of Anatomic and Perinatal Pathology and Cytology, Fernandez Hospital, Hyderabad, Andhra Pradesh, India.
Arch Gynecol Obstet. 2014 Apr;289(4):915-20. doi: 10.1007/s00404-013-3112-5. Epub 2013 Dec 12.
Giant and multilobular endocervical polyps are rare and need to be differentiated from cervical neoplastic lesions.
The authors report a 29-year-old sexually inactive woman presenting with a prolapsed giant endocervical polyp, associated with malodorous discharge and menorrhagia. The wide-based polyp originated in part from the posterior lip of the exocervix and in part from the endocervix. This trilobular pedunculated mass (90 × 50 × 35 mm) had small cysts on the surface and focal areas of haemorrhage. Microscopic examination revealed areas with classic endocervical mucosal polyp histology intimately mixed with expanses of endometrial stroma and occasional endometrial glands. Immunohistochemically the endometrial stroma showed strong CD10 positivity, glands were oestrogen and progesterone receptor positive and Ki-67 proliferation index was low.
Polypoid endometriosis of the cervix is a distinct form of endometriosis that may be mistaken for a neoplasm. Five earlier reports of this entity have not described a prolapsed polyp assuming gigantic proportions. We conclude that this condition be considered in the differential diagnosis of polypoid lesions of the cervix.
巨大型和多叶型宫颈内膜息肉罕见，需要与宫颈肿瘤性病变相鉴别。
作者报告了 1 例 29 岁、无性生活史的女性，表现为脱垂的巨大宫颈内膜息肉，伴有恶臭分泌物和月经过多。宽基底的息肉部分起源于宫颈外口后唇，部分起源于宫颈内口。这个三叶状有蒂肿块（90×50×35mm）表面有小囊肿，并有局灶性出血区。镜下检查显示有典型的宫颈内膜黏膜息肉组织学区域，与扩张的子宫内膜基质密切混合，偶尔有子宫内膜腺体。免疫组化显示子宫内膜基质 CD10 阳性强，腺体雌激素和孕激素受体阳性，Ki-67 增殖指数低。
宫颈息肉样子宫内膜异位症是一种特殊类型的子宫内膜异位症，可能被误诊为肿瘤。此前已有 5 例该疾病的报告，但未描述脱垂的息肉呈巨大比例。我们的结论是，在鉴别诊断宫颈息肉样病变时应考虑这种情况。
