レゼクトスコープを用いて診断したatypical endometrial hyperplasia in endometrial polypの1例

抄録

  Preoperative diagnosis of small uterine endometrial lesions by endometrial curettage biopsy can be difficult because tissue from localized lesions may not be obtained by this procedure. We here report a case of atypical endometrial hyperplasia in an endometrial polyp that was not diagnosed by several endometrial curettage biopsies but was finally diagnosed by resectoscopic partial resection. A 54-year-old woman, gravida 2, para 2 was referred to our hospital because cervical cytology had shown atypical glandular cells-favoring neoplasia. Cervical and endometrial biopsies obtained in our hospital yielded only normal tissue and MRI examination showed no obvious abnormalities. Hysteroscopy revealed a polypoid lesion near the ostium of the left fallopian tube, prompting repeat endometrial curettage biopsy. However, it proved difficult to collect a sample from that polypoid lesion, which was therefore removed via a resectoscope. Histological examination of the specimen thus obtained resulted in a diagnosis of atypical endometrial hyperplasia in an endometrial polyp. Abdominal simple total hysterectomy and bilateral salpingo-oophorectomy was therefore performed. The final pathological diagnosis was also atypical endometrial hyperplasia. We therefore suggest that removal of specimens via a resectoscope may be a useful means of diagnosing endometrial lesions from which it is difficult to collect tissue by endometrial curettage.