Tongsong Theera, Khunamornpong Surapan, Sirikunalai Panarat, Jatavan Thanate
Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand.
BMJ Case Rep. 2014 Apr 10;2014:bcr2013201509. doi: 10.1136/bcr-2013-201509.
The objective of this study was to illustrate a false-positive diagnosis of adherent placenta due to underlying adenomyosis. A 34-year-old woman was diagnosed for placenta previa totalis with adherent placenta at 33 weeks, based on the findings of loss of clear space or distinguishing outline separating the placenta and uterine wall, presence of intraplacental lacunae and densely atypical vessels in the lesion. Caesarean hysterectomy was performed at 35 weeks. Pathological findings revealed placenta previa totalis with adenomyosis beneath the placenta at the lower segment, with no adherent placenta. In conclusion, this report underlines the importance of possible false-positive test of prenatal ultrasound and MRI findings of adherent placenta caused by underlying adenomyosis which could obliterate the outline distinguishing the placenta and myometrium and atypical vessels secondary to decidualisation and hypervascularity from pregnancy. This case may probably encourage physician to beware of false-positive test of adherent placenta due to adenomyosis.
本研究的目的是阐明因潜在的子宫腺肌病导致胎盘植入假阳性诊断的情况。一名34岁女性在孕33周时根据胎盘与子宫壁之间清晰间隙或区分轮廓消失、胎盘内存在腔隙以及病变内密集的非典型血管等表现,被诊断为完全性前置胎盘伴胎盘植入。孕35周时行剖宫产子宫切除术。病理结果显示为完全性前置胎盘,下段胎盘下方存在子宫腺肌病,并无胎盘植入。总之,本报告强调了产前超声和磁共振成像(MRI)检查结果可能出现假阳性的重要性,即潜在的子宫腺肌病可使区分胎盘与子宫肌层的轮廓消失,并产生与蜕膜化和妊娠时血管增生相关的非典型血管,进而导致胎盘植入的假阳性结果。该病例可能会促使医生警惕因子宫腺肌病导致的胎盘植入假阳性检查结果。