Appendiceal perforation secondary to endometriosis with intestinal metaplasia: A case report.
Appendiceal perforation secondary to endometriosis with intestinal metaplasia: A case report.
复制标题
子宫内膜异位症继发于肠道化生的阑尾穿孔：病例报告。
DOI：
10.3892/etm.2023.11961
复制
发表时间：
2023-06
影响因子：
2.7
通讯作者：
Li P
中科院分区：
文献类型：
--
作者：
Wang M;Liu J;Hu B;Wang S;Xie P;Li P
根据临床特征，术前诊断阑尾子宫内膜异位症伴肠化生尤其具有挑战性。在显微镜下，它可以模拟阑尾恶性转化为粘液性肿瘤的过程。本研究报告了一名 47 岁女性的病例，她出现与月经无关的腹痛。术前及腹腔镜评估诊断为慢性阑尾炎。腹腔内不存在粘液性或出血性分泌物。病理学评估显示常规子宫内膜异位症伴有肠型上皮化生。观察到肠型和子宫内膜型内皮细胞角蛋白 (CK)7、配对盒 8、雌激素受体、CK20、尾型同源盒转录因子 2 和粘蛋白 2 免疫反应性的反向模式。阑尾壁被显着水平的无细胞粘蛋白浸润和替代、间质成分的缺乏和 DNA 错配修复蛋白谱对于诊断无阑尾粘液性肿瘤 (AMN) 的阑尾子宫内膜异位症至关重要。在之前报道的病例中，阑尾子宫内膜异位症的病变通常是浅表且较小的，但在我们的病例中是深度侵袭性的。仔细的组织病理学检查对于诊断和区分 AMN 的组织学模仿者是必要的。
Appendiceal endometriosis with intestinal metaplasia is particularly challenging to diagnose preoperatively based on clinical features. Microscopically, it can mimic malignant transformation into mucinous neoplasms of the appendix. The present study reports a case of a 47-year-old woman who presented with abdominal pain that was not related to her menstruation. The preoperative diagnosis and laparoscopic evaluation were chronic appendicitis. No mucinous or haemorrhagic secretions were present within the abdominal cavity. Pathological evaluation revealed conventional endometriosis with intestinal-type metaplasia of the epithelium. An inverse pattern of cytokeratin (CK)7, paired-box 8, estrogen receptor, CK20, caudal type homeobox transcription factor 2 and mucin 2 immunoreactivity between intestinal-type and endometrial-type endothelium was observed. Infiltration and replacement of the appendiceal wall by marked levels of acellular mucin, a lack of stromal components and a DNA mismatch repair protein profile were vital in diagnosing appendiceal endometriosis without appendiceal mucinous neoplasms (AMNs). The lesion of appendiceal endometriosis are usually superficial and small in previously reported cases but was deeply invasive in our case. A careful histopathological examination is necessary for diagnosing and distinguishing the histologic imitators of AMN.
登录
查看更多内容
DOI：
10.1056/nejmoa1614814
发表时间：
2017-05-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
Anglesio MS;Papadopoulos N;Ayhan A;Nazeran TM;Noë M;Horlings HM;Lum A;Jones S;Senz J;Seckin T;Ho J;Wu RC;Lac V;Ogawa H;Tessier-Cloutier B;Alhassan R;Wang A;Wang Y;Cohen JD;Wong F;Hasanovic A;Orr N;Zhang M;Popoli M;McMahon W;Wood LD;Mattox A;Allaire C;Segars J;Williams C;Tomasetti C;Boyd N;Kinzler KW;Gilks CB;Diaz L;Wang TL;Vogelstein B;Yong PJ;Huntsman DG;Shih IM
通讯作者：
Shih IM
影响因子：
3.3
作者：
HAPKE, MR;BIGELOW, B
通讯作者：
BIGELOW, B
影响因子：
3.2
作者：
Klingbeil, Kyle D.;Azab, Basem;Moller, Mecker G.
通讯作者：
Moller, Mecker G.
影响因子：
4.3
作者：
Gao, Lufen;Chen, Hui;Liu, Jing;Wang, Minghua;Lin, Fangfang;Yang, Guang;Lash, Gendie E.;Li, Ping
通讯作者：
Li, Ping
影响因子：
4.6
作者：
Yoo JY;Kim TH;Fazleabas AT;Palomino WA;Ahn SH;Tayade C;Schammel DP;Young SL;Jeong JW;Lessey BA
通讯作者：
Lessey BA