Daya D, O'Connell G, DeNardi F
Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
Mod Pathol. 1995 Aug;8(6):599-602.
We report a unique case of rectal endometriosis mimicking solitary rectal ulcer syndrome. Several rectal biopsies were performed before the correct diagnosis of rectal endometriosis was made. The lesion had striking histologic features resembling colitis cystica profunda. The presence of two types of glands, i.e., colonic glands with marked depletion of mucin and endometrial glands, were readily apparent on immunohistochemical stain using anticarcinoembryonic antigen showing positive cytoplasmic stain for colonic glands but negative for endometrial glands. However, the distinction between colonic and endometrial glands was very difficult on hematoxylin-and-eosin-stained slides. Endometrial stroma was identified only in the sixth biopsy specimen. Although rare, rectal endometriosis should be considered in the differential diagnosis of solitary rectal ulcer syndrome.
我们报告了一例罕见的直肠子宫内膜异位症，其临床表现酷似孤立性直肠溃疡综合征。在正确诊断直肠子宫内膜异位症之前，进行了多次直肠活检。该病变具有显著的组织学特征，类似于深部囊性结肠炎。使用抗癌胚抗原进行免疫组化染色时，两种类型的腺体即黏液明显减少的结肠腺体和子宫内膜腺体很容易区分，结肠腺体细胞质呈阳性染色，而子宫内膜腺体呈阴性染色。然而，在苏木精-伊红染色切片上，结肠腺体和子宫内膜腺体很难区分。仅在第六次活检标本中发现了子宫内膜间质。尽管罕见，但在孤立性直肠溃疡综合征的鉴别诊断中应考虑直肠子宫内膜异位症。
