Ro J Y, Ayala A G, Wishnow K I, Ordóñez N G
Department of Pathology, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030.
Semin Diagn Pathol. 1988 Aug;5(3):301-11.
Despite earlier arguments that the so-called "endometrioid carcinoma" is of Müllerian remnant origin, our clinicopathologic study of 35 cases indicated that it is actually an adenocarcinoma of prostatic duct origin. With respect to histology, it has two growth patterns; type A, an exuberant papillary endometrioid pattern with a focal intraductal component, and type B, less papillary-endometrioid growth and more intraductal components. Immunoperoxidase study showed immunoreactivity for prostatic-specific antigen and prostatic acid phosphatase in all 20 cases tested. Ultrastructural study identified prostatic epithelial cells rather than ciliated endometrial features. In 18 of 35 cases, we identified microacinar carcinoma of the prostate, MDAH grade I, Gleason's combined score 2, 3, or 4. Twenty-two treated patients presented with obstruction, hematuria, or both; 20 had stage C or D disease, suggesting that this tumor is more aggressive than was originally assumed.
尽管早期有观点认为所谓的“子宫内膜样癌”起源于苗勒管残余，但我们对35例病例的临床病理研究表明，它实际上是一种起源于前列腺导管的腺癌。在组织学方面，它有两种生长模式；A型，一种旺盛的乳头状子宫内膜样模式，伴有局灶性导管内成分，B型，较少乳头状子宫内膜样生长，较多导管内成分。免疫过氧化物酶研究显示，在所有20例检测病例中，对前列腺特异性抗原和前列腺酸性磷酸酶均有免疫反应。超微结构研究确定为前列腺上皮细胞，而非纤毛子宫内膜特征。在35例病例中的18例中，我们发现了前列腺微腺泡癌，MDAH I级，Gleason综合评分2、3或4。22例接受治疗的患者出现梗阻、血尿或两者皆有；20例患有C期或D期疾病，表明这种肿瘤比最初认为的更具侵袭性。
