宫颈不典型微腺性增生的临床病理特点及鉴别诊断

Atypical microglandular hyperplasia of the cervix: a study of clinicopathologic features and differential diagnosis

目的 :探讨宫颈不典型微腺性增生 (MGH)的临床病理特征及其鉴别诊断。方法 :观察 3例宫颈不典型MGH的临床病理特点 ,并进行组化和免疫组化染色分析。结果 :病人年龄 2 2～ 35岁 ,3例中 1例为足月孕 ,1例已婚孕并有口服避孕药史。病人无明显症状而于查体时发现宫颈息肉样物 ,最大径不超过 2cm。组织学特点为上皮细胞增生呈实性片状和网状结构 ,细胞胞质嗜酸性、透明状或粘液样 ,少数呈印戒样 ,中度核异型 ,核分裂象 0～ 1个 / 10HPF。可找到灶性典型的MGH。免疫组化染色CEA阴性。 2例分别于 1年和 2年后情况良好。结论 :宫颈不典型MGH是储备细胞增生向腺体分化不充分的形态表现 ,有必要熟悉此特殊类型及其相关病变 。

Purpose To study the the clinicopathologic features and differential diagnosis of atypical microglandular hyperplasia in the cervix. Methods The clinicopathologic features of 3 cases of atypical microglandular hyperplasia of the cervix were studied and the histochemical and immunohistochemical analyses were performed. Results The patients ranged in age from 22 to 35,one having a history of pregnancy and oral contraceptive use and another one being during pregnancy. Asymptomatic patients were found to have a cervical polyp measuring less than 2 cm on routine examination. The histologic features were the presence of solid and reticular patterns of the proliferating epithelial cells. The cells in these areas had eosinophilic, clear, or mucinous cytoplasm signet ring cells were occasionally seen.They had moderate nuclear atypia and 0 or 1 mitotic figure per 10 high power fields. The foci of typical microglandular hyperplasia could be found in a small portion of the lesions. Immunohistochemical staining for CEA was negtive. Two patients were well after a follow up of 1 and 2 years respectively. Conclusions Atypical microglandular hyperplasia is an unusual form of reserve cell hyperplasia with poor glandular differentiation. It is important to be aware of the atypical form and its related diseases to avoide potentially serious errors in diagnosis.