原发性子宫内膜鳞癌1例报道及文献复习

Primary squamous cell carcinoma of the endometrium: a case report and literature review

目的 探讨子宫内膜鳞癌的临床病理特点。方法 对 1例原发性子宫内膜鳞癌进行免疫组化观察并结合文献复习其临床病理特点。结果 原发性子宫内膜鳞癌镜下为伴角化珠及间桥的高分化鳞癌 ,浸润子宫壁肌层内 2 /3,淋巴管见多发性瘤栓。子宫颈和颈管正常。免疫表型 :高分子CK( )、低分子CK( )、ER(+)、PR( )、HPV胞质阳性、p5 3( )及P gp( )。结论 原发性子宫内膜鳞癌非常罕见 ,恶性度高。腺上皮鳞化癌变 ,可能是其病变过程 ;HPV的作用还不清楚。该肿瘤术前诊断困难 ,确诊主要靠术后病理检查。

Purpose To explore the clinicopathological features of primary squamous cell carcinoma of the endometrium(PSCCE). Methods The pathologic changes and immunohistochemical findings in the case of PSCCE were observed with review of the literature. Results A 62 years old female who was increasing secretion of white and accretion of uterus. The tumour of uterus was discovered after the abdominal hysterectomy and bilateral salpingop-oophorectomy. Microscopic findings were consistent with PSCCE which fulfills Fluhmann’s criteria. It was highly differentiated squamous cell carcinoma with HPV(+), CK(), ER(+), PR(), P-glycoprotein() and p53(). Conclusion PSCCE is extremely rare and highly malignant and preoperative diagnosis is difficult. These results support the change with squamous metaplasia to carcinoma as a possible pathogenetic process. However, HPV’s role remains uncertain.