Duncan D A, Varner R E, Mazur M T
Department of Pathology, University of Alabama, Birmingham.
Hum Pathol. 1989 Oct;20(10):1021-4. doi: 10.1016/0046-8177(89)90275-x.
A case of herpes simplex virus (HSV) infection was diagnosed by biopsy of the cervix and endometrium in a 28-year-old woman with abnormal uterine bleeding. The cervical biopsy demonstrated surface ulceration and underlying patchy necrosis of endocervical clefts and stroma. The endometrium was late secretory, with striking patchy necrosis of gland epithelium and stromal cells. Both sites contained occasional epithelial and stromal cells with nuclear inclusions consistent with HSV infection. Viral culture further confirmed the presence of HSV. Immunohistochemistry demonstrated the presence of HSV antigens in the tissue, and ultrastructural study of the endometrium revealed viral particles within epithelial and stromal cells. The results suggest endometrial involvement via an ascending infection from the cervix. Recognition of this unusual pattern of endometrial inflammation may facilitate diagnosis of additional cases.
一名28岁子宫异常出血的女性患者，经宫颈和子宫内膜活检诊断为单纯疱疹病毒（HSV）感染。宫颈活检显示宫颈管裂隙和间质表面溃疡及深层片状坏死。子宫内膜处于分泌晚期，腺上皮和基质细胞有明显的片状坏死。两个部位均偶见上皮和基质细胞有与HSV感染相符的核内包涵体。病毒培养进一步证实了HSV的存在。免疫组织化学显示组织中存在HSV抗原，子宫内膜的超微结构研究显示上皮和基质细胞内有病毒颗粒。结果提示子宫内膜受累是通过宫颈上行感染所致。认识这种不寻常的子宫内膜炎症模式可能有助于诊断更多病例。
