Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (1): 82-86.doi: 10.24920/003911

• 病例报告 • 上一篇    

非典型息肉样腺肌瘤的MRI和经阴道超声表现:1例报道

谭娅1,胡雪2,宋鑫1,张文君1,*()   

  1. 1湖北医药学院太和医院超声医学科,湖北十堰442000,中国
    2湖北医药学院太和医院妇产科医学中心,湖北十堰442000,中国
  • 收稿日期:2021-04-06 接受日期:2021-07-09 出版日期:2022-03-31 发布日期:2022-03-04
  • 通讯作者: 张文君 E-mail:pulushi38@126.com

MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report

Ya Tan1,Xue Hu2,Xin Song1,Wenjun Zhang1,*()   

  1. 1Department of Ultrasonography, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
    2Obstetrics and Gynecology Medical Center, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
  • Received:2021-04-06 Accepted:2021-07-09 Published:2022-03-31 Online:2022-03-04
  • Contact: Wenjun Zhang E-mail:pulushi38@126.com

摘要:

非典型息肉样腺肌瘤(atypical polypoid adenomyoma,APA)是一种罕见类型的息肉,其病理特征主要是肌瘤间质和子宫内膜腺体相间。APA主要发生在绝经前女性,很少发生在伴有不规则阴道出血的绝经后女性。本例76岁绝经女性表现为不规则阴道出血,最终病理诊断为APA。APA在手术前不易诊断:一方面,APA的影像学和临床特征无明显的特殊性,尤其是在与子宫内膜癌的鉴别方面;另一方面,APA有一个蒂,可以附着在宫腔的任何部分,这可能导致肿块与宫腔壁之间形成假腔,因此,在没有宫腔镜检查的情况下获取病理组织时,很容易通过假腔获得子宫内膜组织,而不是肿块的病理组织。因此,术前影像学检查对临床医师诊断APA具有重要意义;同时,可在宫腔镜直视条件下获得APA的病理组织。

关键词: 绝经后, 非典型息肉样腺肌瘤, 不规则阴道出血, MRI, 阴道超声

Abstract:

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.

Key words: postmenopausal, atypical polypoid adenomyoma, irregular vaginal bleeding, MRI, transvaginal ultrasound

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