female genital tract

女性生殖道
  • 文章类型: Letter
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  • 文章类型: Case Reports
    背景:Peutz-Jeghers综合征(PJS)的特征是胃肠道中存在错构瘤性息肉和嘴唇上的粘膜皮肤色素沉着,口腔粘膜,鼻子,手指,和脚趾。女性生殖道的同步粘液性化生和瘤形成(SMMN-FGT)是指在至少两个部位发生多灶性粘液性病变,包括子宫颈,子宫,输卵管,和卵巢,在女性生殖道。SMMN-FGT和PJS是发病率非常低的罕见疾病,尤其是同时发生的时候。
    方法:我们报告了一个病例,其中一名左卵巢有较大肿块的妇女接受了妇科手术,被诊断为宫颈胃型腺癌和子宫内膜粘液性病变,双侧输卵管,和卵巢,即,SMMN-FGT,通过术后石蜡病理学检查。患者因腹胀和增大而求医。妇科超声显示骨盆有多房性囊性肿块,而血清肿瘤标志物在正常范围内,碳水化合物抗原199和碳水化合物抗原125水平轻度升高。宫颈薄层细胞学检查结果为阴性。患者有PJS家族史,皮肤和粘膜有黑点,年龄8岁。由于肠梗阻和肠套叠,她接受了多次部分小肠切除术和胃肠道息肉切除术。她接受了左附件切除术,子宫切除术,右输卵管切除术,大网膜切除,阑尾切除术和右卵巢活检,并接受了6个疗程的洛普加卡铂辅助化疗。基因检测显示丝氨酸苏氨酸激酶11种系杂合突变,治疗后18个月随访期间无复发迹象。
    结论:这是一种罕见的病例,其中PJS并发SMMN-FGT。由于其极端稀有,没有指导方针,但报道的病例似乎表明预后不良。我们回顾性回顾了所有PJS和SMMN-FGT之间的碰撞病例,并探讨了临床特征,病理特征,诊断,治疗方法,两种疾病并存时的预后。目的是加深临床医生对这种疾病的认识,以便早期发现,诊断和治疗。
    BACKGROUND: Peutz-Jeghers syndrome (PJS) is characterized by the presence of hamartomatous polyps in the gastrointestinal tract and mucocutaneous pigmentation on the lips, oral mucosa, nose, fingers, and toes. Synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT) refers to the occurrence of multifocal mucinous lesions in at least two sites, including the cervix, uterus, fallopian tubes, and ovaries, in the female genital tract. SMMN-FGT and PJS are rare diseases with a very low incidence, especially when occurring simultaneously.
    METHODS: We report a case in which a woman with a large mass on the left ovary underwent a gynecological surgery and was diagnosed with cervical gastric-type adenocarcinoma and mucinous lesions in the endometrium, bilateral fallopian tubes, and ovary, i.e., SMMN-FGT, by postoperative paraffin pathology. The patient sought medical attention for abdominal distension and enlargement. A gynecological ultrasound revealed a multilocular cystic mass in the pelvis, while serum tumor markers were within normal limits, with mildly elevated carbohydrate antigen 199 and carbohydrate antigen 125 levels. Cervical thin-prep cytology test result was negative. The patient had a family history of PJS with black spots on her skin and mucous membranes since the age of 8 years. She underwent multiple partial small bowel resections and gastrointestinal polypectomy owing to intestinal obstruction and intussusception. She underwent left adnexectomy, hysterectomy, right salpingectomy, greater omental resection, appendectomy and right ovary biopsy, and received six courses of adjuvant chemotherapy with Lopressor plus Carboplatin. Genetic testing revealed a heterozygous serine threonine kinase 11 germline mutation and there were no signs of recurrence during the 18-month follow-up period after treatment.
    CONCLUSIONS: This is a rare case in which PJS was complicated by SMMN-FGT. Owing to its extreme rarity, there are no guidelines, but reported cases appear to indicate a poor prognosis. We retrospectively reviewed all cases of collisions between PJS and SMMN-FGT and explored the clinical features, pathological characteristics, diagnosis, treatment methods, and prognosis when the two diseases coexisted. The aim is to deepen the clinicians\' understanding of this disease for early detection, diagnosis and treatment.
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  • 文章类型: Review
    目的:女性生殖器肺泡软组织肉瘤(ASPS)罕见,与其他部位的ASPS相比,预后良好。我们报告了我们处理子宫体ASPS(UCASPS)病例的经验,并对女性生殖道不同部位ASPS的预后进行了文献综述。
    方法:本报告为一名33岁女性,患有UCASPS。她接受了保留子宫的肿瘤切除术,随访时间最长(155个月),没有复发。
    结论:UCASPS的预后优于宫颈ASPS,子宫下段,外阴阴道区和会阴.我们建议对患有UCASPS的年轻女性进行保守治疗。
    OBJECTIVE: Female genital alveolar soft part sarcoma (ASPS) is rare and has a favourable prognosis compared to ASPS from other sites. We reported our experience to manage a case with uterine corpus ASPS (UC ASPS) and conducted a literature review on prognosis of ASPS from different sites of female genital tract.
    METHODS: This report represented a 33-year-old woman who had UC ASPS. She received tumor excision with uterine preservation and had the longest follow-up time (155 months) without recurrence in the literature.
    CONCLUSIONS: UC ASPS has better prognosis than ASPS from the uterine cervix, the low uterine segment, vulvovaginal area and perineum. We recommended conservative treatment for young women with UC ASPS.
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  • 文章类型: Case Reports
    淋巴瘤是常见的实体恶性肿瘤。它们与大量的发病率和死亡率有关。霍奇金淋巴瘤(HL)和非HL(NHL)是淋巴瘤的亚型。淋巴结是最常见的累及部位,尽管几乎任何器官都可能参与其中。NHL具有结外受累的优势。原发性子宫和卵巢NHL很少。然而,在晚期全身性疾病中,可以看到继发性子宫-卵巢受累。18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDGPET/CT)是淋巴瘤的关键成像方式。它在预处理阶段教唆,治疗后复诊,和监视。我们介绍了三例继发性子宫卵巢受累的IV期NHL病例。FDGPET/CT作为基线成像模式确定了疾病负担和器官受累。
    Lymphomas are common solid malignancies. They are associated with substantial morbidity and mortality. Hodgkin\'s lymphoma (HL) and Non-HL (NHL) are subtypes of lymphoma. Lymph nodes are the most common site of involvement, though practically any organ may be involved. NHL has preponderance for extranodal involvement. Primary uterine and ovarian NHL is scarce. However, in advanced systemic disease, secondary utero-ovarian involvement may be seen. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is a pivotal imaging modality in lymphomas. It abets in pretreatment staging, posttherapy restaging, and surveillance. We present three stage-IV NHL cases with secondary utero-ovarian involvement. FDG PET/CT as a baseline imaging modality established the disease burden and organ involvement.
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  • 文章类型: Journal Article
    (1)背景:肉芽肿性血管炎(GPA)是一种模仿妇科癌症的坏死性血管炎。在GPA患者中,泌尿生殖系统的影响<1%。该研究的目的是对妇科受累的GPA患者的文献进行系统回顾。(2)方法:从开始到2021年7月,检索PubMed和Embase中具有妇科受累的GPA患者医学主题词(MeSH)和自由文本术语。排除标准是其他语言,评论文章,怀孕,生育力,或男性患者。提取了临床演变的数据,症状,检查结果,诊断延迟,治疗,结果,患者状态,和后续行动。(3)结果:17项研究包括来自GPA和原发性或复发性妇科受累患者的数据。68%的作者认为该患者患有癌症。主要的妇科疾病症状是出血,但独特的妇科症状很少见(耳鼻喉科:63%,肺:44%,肾脏-泌尿道:53%)。GPA会影响生殖道的所有区域,但最常见的位置是子宫颈。GPA的药物治疗是有效的。(4)结论:当溃疡恶性表现为宫颈或阴道肿块的活检即使没有特异性,也没有恶性肿瘤时,必须考虑女性生殖道的GPA。指示风湿病咨询。
    (1) Background: Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitis that mimics gynecologic cancer. In GPA patients, the genitourinary system is affected in <1%. The objective of the study was to provide a systematic review of the literature of GPA patients with gynecological involvement. (2) Methods: PubMed and Embase were searched from inception to July 2021 for GPA patients with gynecological involvement Medical Subject Headings (MeSH) and free-text terms. Exclusion criteria were other language, review articles, pregnancy, fertility, or male patients. Data were extracted on clinical evolution, symptoms, examinations findings, diagnosis delay, treatment, outcome, patient status, and follow-up. (3) Results: Seventeen studies included data from patients with GPA and primary or relapsed gynecological involvement. 68% of the authors of this review thought the patient had cancer. The main gynecological symptom is bleeding, but exclusive gynecologic symptomatology is rare (ENT: 63%, lungs: 44%, kidneys-urinary tract: 53%). GPA could affect all areas of the genital tract, but the most frequent location is the uterine cervix. Medical treatment for GPA is effective. (4) Conclusions: GPA of the female genital tract must be considered when biopsies of an ulcerated malignant-appearing cervical or vaginal mass are negative for malignancy even when they are unspecific. Rheumatology consultation is indicated.
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  • 文章类型: Case Reports
    背景:宫颈息肉是女性生殖道中最常见的良性增生性病变之一,通常由宫颈管引起,被认为是由于长期慢性炎症引起的反应性变化的结果,多党,和异物。宫颈息肉通常尺寸较小(小于4厘米),常见于成年女性;然而,还报道了一些巨大息肉病例,这些病变在儿童中很少发生。宫颈息肉中的异型和恶性转化被认为是非常罕见的。
    方法:我们介绍了一个10岁的阿富汗女孩的案例,该女孩有一个巨大的带蒂肿块从子宫颈突出,并伴有腹痛和肿块感。通过手术干预将肿块完全切除,并将标本提交组织病理学评估。经过肉眼和显微镜检查,观察到具有成熟软骨形式的异源间充质组织的错构瘤性息肉的特征性发现。据我们所知,这是该年龄组首例巨大(17.5厘米)的子宫颈错构瘤性息肉。
    结论:10岁以下的患者很少发生巨大错构瘤性宫颈息肉。这些病变大多数是良性的;然而,还报告了一些恶性转化的病例,这需要对病变的病因和性质进行详细的研究。
    BACKGROUND: Polyps of the uterine cervix are one of the most common benign hyperplastic lesions occurring in the female genital tract that usually arise from the endocervical canal and are believed to be the result of reactive changes due to long-standing chronic inflammation, multiparty, and foreign bodies. Cervical polyps are usually small in size (less than 4 cm) that are commonly found in adult women; however, a few cases of giant polyps and the rare occurrence of these lesions in children have also been reported. Heterotopias and malignant transformation in cervical polyps are considered to be very rare.
    METHODS: We present the case of a 10-year-old Afghan girl with a giant pedunculated mass protruding out of the uterine cervix that was accompanied by abdominal pain and mass sensation. The mass was completely excised by surgical intervention and the specimen was submitted for histopathological evaluation. Upon gross and microscopic examination, the characteristic findings of a hamartomatous polyp with heterologous mesenchymal tissue in the form of mature cartilage were seen. To the best of our knowledge, this is the first case of a giant (17.5 cm) hamartomatous polyp of the uterine cervix in this age group.
    CONCLUSIONS: Giant hamartomatous cervical polyps rarely occur in patients below 10 years of age. The majority of these lesions are benign; however, a few cases with malignant transformation are also reported, which demands elaborate investigations into the etiopathogenesis and nature of the lesions.
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  • 文章类型: Case Reports
    Molluscum Contagiosum (MC) is a common viral infection of skin caused by a double stranded DNA Pox virus affecting both adults and children. MC is primarily an infection of school-going children (one to five years), occasionally it affects adults and immunocompromised individuals. Transmission of virus occurs by direct contact with infected persons or contaminated objects. Most common sites are skin of face, trunk and extremities in children, genitals in adults and rarely palms, soles and mucous membranes. The occurrence of MC in genitals is lowest (3%). We present a case report of Molluscum Contagiosum of cervix which is a rare site; only one case has been reported in medical literature till date.
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  • 文章类型: Case Reports
    We report a rare case of extranodal NK/T-cell lymphoma, nasal type of the uterine cervix that showed cytologic features mimicking cervical cancer. A 65-year-old woman presented with vaginal bleeding. Gynecological examination revealed a bulky tumor of the cervix. A conventional Papanicolaou-stained cervical smear showed hypercellularity consisting of numerous variably sized cohesive clusters that mimicked epithelial tumors, with a necrotic and inflammatory background. A small number of individually scattered cells were also identified. These scattered cells showed pleomorphic, often cleaved, or horseshoe-shaped nuclei and pale cytoplasm. Biopsy specimens revealed a diffuse growth of atypical cells with an angiocentric pattern. Extensive necrosis and infiltration of inflammatory cells were present. There were numerous mitotic figures. The tumor cells were positive for CD45RO, CD3ε, CD56, granzyme B, TIA-1, CD7, and Epstein-Barr virus (EBV)-encoded small RNA (EBER) by in situ hybridization, and negative for cytokeratin, chromogranin A, synaptophysin, CD4, CD5, CD8, CD20, and CD30. Based on these findings, this tumor was diagnosed as extranodal NK/T-cell lymphoma, nasal type of the uterine cervix.
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  • 文章类型: Case Reports
    乳腺浸润性小叶癌(ILC)表现出异常的临床病理,放射学,组织学,和转移模式。我们在这里介绍了两例乳腺ILC,其表现出异常的子宫转移模式。我们的第一例患者因阴道大量出血而向主要妇科医生就诊,并接受了全腹部子宫切除术和双侧输卵管卵巢切除术。四年前,她从左乳房切除了纤维腺瘤。组织病理学显示小叶癌弥漫性浸润子宫,子宫颈,双侧卵巢。对左乳房的回顾性检查显示,沿着先前的纤维腺瘤切除瘢痕硬结。疤痕活检提示小叶癌。我们的第二例患者表现出坚硬的宫颈硬结肿块,模仿了原发性宫颈癌。四年前,她患有右乳房ILC,接受了乳房切除术,然后进行了辅助化疗和放疗。她在服用他莫昔芬。影像学检查的进一步评估显示广泛的腹腔内疾病,涉及腹膜伴中度腹水,附件肿块,和融合的主动脉旁淋巴结肿块。宫颈活检证实小叶癌转移。对于有乳腺癌病史且存在异常阴道出血的女性,应考虑生殖道转移受累。可疑的骨盆检查,或放射学发现。我们建议,即使患者在几年内没有疾病,也要通过活检对此类患者进行大力筛查。区分转移与生殖道原发癌至关重要,因为每种转移的治疗方法都存在巨大差异。
    Invasive lobular carcinoma (ILC) of the breast exhibits unusual clinicopathological, radiological, histological, and metastatic patterns. We present here two cases of ILC of the breast that presented with an unusual pattern of metastasis involving the uterus. Our first patient presented to her primary gynaecologist with profuse vaginal bleeding and underwent total abdominal hysterectomy and bilateral salpingo-oophrectomy. She had fibroadenoma excised from her left breast four years previously. Histopathology revealed lobular carcinoma diffusely infiltrating uterus, cervix, and bilateral ovaries. Retrospective examination of the left breast showed induration along the previous fibroadenoma excision scar. A biopsy from the scar suggested lobular carcinoma. Our second patient presented with a hard indurated cervix mass that mimicked primary cervix carcinoma. She had ILC of the right breast four years previously for which she underwent mastectomy followed by adjuvant chemotherapy and radiotherapy. She was on tamoxifen. Further evaluation at presentation with imaging showed extensive intra-abdominal disease involving peritoneum with moderate ascites, adnexal masses, and confluent para-aortic nodal mass. A cervix biopsy confirmed metastasis from lobular carcinoma. Metastatic involvement of the genital tract should be considered in women with a history of breast cancer who present with abnormal vaginal bleeding, suspicious pelvic examination, or radiological findings. We suggest such patient be vigorously screened with biopsy even if the patient is disease-free for several years. It is crucial to differentiate the metastasis from primary carcinoma of the genital tract as there are vast differences in the management of each.
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  • 文章类型: Case Reports
    巨细胞动脉炎(GCA)是一种免疫介导的大型和中型血管的血管炎,通常影响颅内动脉,通常发生在老年人身上。女性生殖道的GCA极为罕见,英文文献中仅报道了31例。一名83岁的绝经后阴道出血的白人女性在盆腔超声检查中发现子宫内膜息肉,随后进行了息肉切除术,随后进行了子宫切除术和双侧输卵管卵巢切除术。显微镜检查显示分化良好的子宫内膜样腺癌。有趣的是,经典的GCA涉及许多子宫颈的中小型动脉,子宫肌层,双侧输卵管,卵巢也被确认。血液学评估显示边缘区淋巴瘤异常罕见的20q缺失。随后进行双侧颞动脉活检,在显微镜下显示GCA。开始使用皮质类固醇改善了她的风湿性多肌痛症状。患者随访3年,情况良好。据我们所知,这是第一例女性生殖道GCA与淋巴瘤相关,第二例边缘区淋巴瘤与新的20q缺失。
    Giant cell arteritis (GCA) is an immunologically mediated vasculitis of large and medium-sized vessels, typically affecting the cranial arteries and usually occurring in the elderly. GCA of the female genital tract is extremely rare with only 31 cases reported in the English literature. An 83-year-old white female with postmenopausal vaginal bleeding revealed an endometrial polyp on pelvic ultrasonography following which polypectomy and subsequently hysterectomy with bilateral salpingo-oophorectomy was done. Microscopy revealed a well-differentiated endometrioid adenocarcinoma. Interestingly, classic GCA involving numerous small to medium-sized arteries of the cervix, myometrium, bilateral fallopian tubes, and ovaries was also identified. Hematologic evaluation revealed marginal zone lymphoma with an exceptionally rare 20q deletion. Bilateral temporal artery biopsy was done subsequently, which exhibited GCA on microscopy. Corticosteroid was started that improved her polymyalgia rheumatica symptoms. The patient is on follow-up for 3 years and is doing well. To our knowledge, this is the first case of GCA of the female genital tract associated with a lymphoma and the second case of marginal zone lymphoma with the novel 20q deletion.
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