Symonds D A, Reed T P, Didolkar S M, Graham R R
Department of Laboratory Medicine, Union Memorial Hospital, Baltimore, Maryland 21218, USA.
J Reprod Med. 1997 Jan;42(1):39-43.
To evaluate cervical endometriosis as a source of abnormal glandular cells in cervicovaginal smears.
Histologically documented cases of cervical endometriosis with concurrent cervicovaginal smears were reviewed. The cytologic specimens were evaluated for the presence of glandular abnormalities.
There were eight cases of superficial endometriosis (five of which had concurrent tuboendometrioid glandular metaplasia) and two cases of deep endometriosis in this series. Five of the eight cases of superficial endometriosis had abnormal glandular cells in the smears; neither of two cases of deep endometriosis had glandular abnormalities. Four of the eight cases of superficial endometriosis had previously undergone conization for cervical intraepithelial neoplasia (CIN) (squamous intraepithelial lesion [SIL]) and were being monitored for recurrence. Of the five cases of atypical glandular cells of unknown significance (AGUS), one case had concurrent high grade CIN (SIL). Another case was originally misinterpreted as recurrent glandular dysplasia.
Physicians monitoring patients after treatment for CIN need to be aware that endometriosis and tuboendometrioid metaplasia may be the source of atypical glandular cells and on occasion may be subject to misinterpretation.
评估宫颈子宫内膜异位症作为宫颈阴道涂片异常腺细胞来源的情况。
回顾经组织学证实的宫颈子宫内膜异位症并发宫颈阴道涂片的病例。对细胞学标本进行腺细胞异常情况评估。
本系列中有8例浅表性子宫内膜异位症(其中5例并发输卵管子宫内膜样腺化生)和2例深部子宫内膜异位症。8例浅表性子宫内膜异位症中有5例涂片存在腺细胞异常;2例深部子宫内膜异位症均无腺细胞异常。8例浅表性子宫内膜异位症中有4例先前因宫颈上皮内瘤变(CIN)(鳞状上皮内病变[SIL])接受过锥切术,正在接受复发监测。在5例意义不明的非典型腺细胞(AGUS)病例中,1例并发高级别CIN(SIL)。另一例最初被误诊为复发性腺发育异常。
在CIN治疗后对患者进行监测的医生需要意识到,子宫内膜异位症和输卵管子宫内膜样化生可能是非典型腺细胞的来源,有时可能会被误诊。