文献类型：期刊文献

中文题名：子宫颈高级别鳞状上皮内病变浅表扩散累及子宫内膜和输卵管1例

英文题名：Intrauterine infection leading to congenital cutaneous candidiasis in one of twin extremely preterm infants:A case report

作者：单莹莹[1];曹石[2];赵静[1];李进[1];舍雅莉[3]

第一作者：单莹莹

机构：[1]甘肃中医药大学第一临床医学院,兰州730000;[2]兰州大学第一医院病理科,兰州730000;[3]甘肃中医药大学基础医学院,兰州730000

第一机构：甘肃中医药大学临床医学院

年份：2025

卷号：45

期号：8

起止页码：1077

中文期刊名：临床与病理杂志

外文期刊名：Journal of Clinical and Pathological Research

语种：中文

中文关键词：子宫颈;高级别鳞状上皮内病变;子宫内膜;输卵管;表面扩散

外文关键词：cervix uteri;high-grade squamous intraepithelial lesion;endometrium;fallopian tube;superficial spread

摘要：直接蔓延是宫颈癌常见的转移途径之一,是指癌组织直接浸润,向邻近组织及器官扩散,常向下累及阴道及宫旁组织,而逆向累及宫腔者罕见。2024年4月13日甘肃省第三人民医院收治1例62岁阴道流液的女性患者,行宫颈液基薄层细胞学检查,提示为非典型鳞状上皮细胞。7个月后于兰州大学第一医院复诊,行阴道镜检查及活体组织检查,确诊为子宫颈高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL);行腹腔镜下子宫和双侧附件切除术。病理诊断结果:1)子宫颈HSIL[宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅲ级]并累及腺体;2)子宫内膜全层HSIL(CINⅢ级);3)右侧输卵管鳞化伴HSIL(CINⅢ级)。该病理结果提示子宫颈HSIL可直接经黏膜表面浅表扩散,逆向累及子宫内膜及输卵管,呈现一种罕见的特殊播散模式。建议对高危患者加强随访监测,必要时行分段诊刮术以排除隐匿病变。
Cervical carcinoma most commonly spreads by direct extension,invading adjacent tissues and organs,typically downward into the uterine cavity is exceedingly rare.On April 13,2024,a 62-year-old female patient with vaginal discharge was admitted to the Third People’s Hospital of Gansu Province.Liquid-based cytology showed atypical squamous epithelial cells.Seven months later,the patient was re-examined at the First Hospital of Lanzhou University,where colposcopic biopsy confirmed a high-grade squamous intraepithelial lesion(HSIL)of the cervix.The patient underwent laparoscopic hysterectomy with bilateral salpingo-oophorectomy.Pathological examination revealed:1)Cervical HSIL[cervical intraepithelial neoplasia(CIN)gradeⅢ]with glandular involvement;2)HSIL(CINⅢ)involving the full thickness of the endometrium;3)right fallopian tube showing squamous metaplasia with HSIL(CINⅢ).These findings suggest that cervical HSIL can extend superficially along the mucosal surface in a retrograde manner to involve the endometrium and fallopian tube,representing a rare and distinct pattern of dissemination.High-risk patients should receive close follow-up,and staged curettage should be considered when necessary to exclude occult lesions.