PDF(Pubmed)
Abstract：
Although imaging studies are not typically performed for clinical diagnosis of cervicitis, in this case magnetic resonance imaging (MRI) was performed because a lesion with a tumor-like gross appearance was found in the uterine cervix. We present a case of cervicitis in which clinical, imaging and pathological features overlapped with those of gastric-type mucinous adenocarcinoma (GAS). The patient, a 30-year-old woman, was referred to a gynecologist with a complaint of watery vaginal discharge. On visual examination, the uterine cervix was irregularly enlarged and bled easily, suggesting cervical cancer. The next day, the patient had a fever of 39°C and blisters appeared on her vulva due to herpes simplex virus type II infection. MRI showed a diffusely enlarged cervix with poorly marginated high signal intensity on T2-weighted imaging (WI) and apparent diffusion coefficient map as well as strong enhancement on contrast-enhanced T1WI, which are findings consistent with GAS. Although a punch biopsy showed only mild atypia of the cervical glands, this was not enough to completely rule out GAS. Consequently, laser conization of the lesion was performed for definitive diagnosis, and the diagnosis of cervicitis was made. Acute cervicitis can be difficult to differentiate from GAS based on symptoms, results of cervical biopsy and MR imaging because of their overlapping features. Even when a patient presents with a lesion with tumor-like gross appearance, acute cervicitis should be included in the differential diagnosis if the result of cervical biopsy is negative, especially when accompanied by infection-like fever.
摘要：
虽然影像学检查通常不用于临床诊断宫颈炎，在这种情况下，进行了磁共振成像（MRI），因为在子宫颈中发现了具有肿瘤样外观的病变。我们介绍了一个宫颈炎的病例，其中临床上，影像学和病理学特征与胃型粘液腺癌（GAS）重叠。病人,一个30岁的女人,被转诊给妇科医生，主诉阴道分泌物呈水样。目视检查,子宫颈不规则增大，容易出血，提示宫颈癌。第二天,患者因单纯疱疹病毒II型感染而发热39°C,外阴出现水疱.MRI在T2加权成像（WI）和表观扩散系数图上显示子宫颈弥漫性增大，高信号强度边缘差，对比增强的T1WI增强，这些结果与GAS一致。尽管穿刺活检显示宫颈腺体只有轻度的异型性，这还不足以完全排除气体。因此,对病变进行激光锥切术以明确诊断，并诊断为宫颈炎。根据症状很难将急性宫颈炎与GAS区分开来，宫颈活检和磁共振成像的结果，因为它们的重叠特征。即使患者出现肿瘤样大体外观的病变，如果宫颈活检结果为阴性，则应将急性宫颈炎纳入鉴别诊断，尤其是伴有感染样发热时。
