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病例报告:一例酷似宫颈恶性肿瘤的软斑病罕见病例:病例报告及文献复习

Case report: A rare case of malacoplakia resembling a malignant tumor of the cervix: a case report and review of the literature.

作者信息

Li Jiaorong, Mi Jiaying, Wang Juanjuan, Zhuo Zhihong

机构信息

Department of Gynecology, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China.

Department of Pathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo, Zhejiang, China.

出版信息

Front Med (Lausanne). 2024 Jun 4;11:1409239. doi: 10.3389/fmed.2024.1409239. eCollection 2024.

Abstract

Malacoplakia is a rare chronic granulomatous disease that mostly affects the gastrointestinal tract and urinary tract of immunocompromised patients; malacoplakia rarely effects the female reproductive tract. Here, we report a 56-year-old patient who underwent thymectomy for thymoma and myasthenia gravis prior to developing cervical and vaginal malacoplakia. The patient presented with recurrent vaginal bleeding. We discovered that there were alterations in the cervical cauliflower pattern during colposcopy, which is suggestive of cervical cancer. Pathological examination of the lesion tissue showed that a large number of macrophages aggregated, and M-G bodies with concentric circles and refractive properties were observed between cells. Immunostaining for CD68 and CD163 was positive, and special staining for D-PAS and PAS was positive. The discovery of in bacterial culture can aid in the diagnosis of malacoplakia. Following surgery, we performed vaginal lavage with antibiotics in addition to resection of local cervical and vaginal lesions. This study provides a fresh perspective on the management of genital malacoplakia.

摘要

软斑病是一种罕见的慢性肉芽肿性疾病,主要影响免疫功能低下患者的胃肠道和泌尿道;软斑病很少累及女性生殖道。在此,我们报告一名56岁患者,该患者在发生宫颈和阴道软斑病之前因胸腺瘤和重症肌无力接受了胸腺切除术。患者出现反复阴道出血。我们在阴道镜检查中发现宫颈呈菜花状改变,提示宫颈癌。病变组织的病理检查显示大量巨噬细胞聚集,细胞间可见具有同心圆和折光性的M-G小体。CD68和CD163免疫染色呈阳性,D-PAS和PAS特殊染色呈阳性。细菌培养中 的发现有助于软斑病的诊断。手术后,除了切除局部宫颈和阴道病变外,我们还用抗生素进行了阴道灌洗。本研究为生殖器软斑病的治疗提供了新的视角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb1f/11183279/61120283e98a/fmed-11-1409239-g0001.jpg

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