{"title":"子宫内膜的复杂乳头状增生：一个罕见的病例报告与细胞病理学特征和诊断意义。","authors":"Renjie Wang, Yinghong Wu, Zhihong Jia","doi":"10.1186/s13000-025-01667-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Complex papillary hyperplasia of the endometrium (CPHE) is a rare benign lesion with overlapping features of malignancy, posing significant diagnostic challenges. This case highlights the importance of multidisciplinary evaluation to avoid misdiagnosis and overtreatment.</p><p><strong>Case presentation: </strong>A 49-year-old premenopausal woman presented with irregular vaginal bleeding. Histopathological examination revealed multifocal lesions confined within and on the surface of endometrial polyps, exhibiting complex papillary structures with bland cytology. Immunohistochemistry showed strong ER/PR positivity and retained PTEN expression, while molecular analysis confirmed the absence of high-risk mutations (PTEN, PIK3CA, TP53, CTNNB1).</p><p><strong>Conclusions: </strong>CPHE requires integration of histopathology, immunohistochemistry, and molecular diagnostics to distinguish it from malignancies. Conservative management is justified in molecularly confirmed cases.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"20 1","pages":"63"},"PeriodicalIF":2.4000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105174/pdf/","citationCount":"0","resultStr":"{\"title\":\"Complex papillary hyperplasia of the endometrium: an uncommon case report with cytopathological features and diagnostic implications.\",\"authors\":\"Renjie Wang, Yinghong Wu, Zhihong Jia\",\"doi\":\"10.1186/s13000-025-01667-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Complex papillary hyperplasia of the endometrium (CPHE) is a rare benign lesion with overlapping features of malignancy, posing significant diagnostic challenges. This case highlights the importance of multidisciplinary evaluation to avoid misdiagnosis and overtreatment.</p><p><strong>Case presentation: </strong>A 49-year-old premenopausal woman presented with irregular vaginal bleeding. Histopathological examination revealed multifocal lesions confined within and on the surface of endometrial polyps, exhibiting complex papillary structures with bland cytology. Immunohistochemistry showed strong ER/PR positivity and retained PTEN expression, while molecular analysis confirmed the absence of high-risk mutations (PTEN, PIK3CA, TP53, CTNNB1).</p><p><strong>Conclusions: </strong>CPHE requires integration of histopathology, immunohistochemistry, and molecular diagnostics to distinguish it from malignancies. Conservative management is justified in molecularly confirmed cases.</p>\",\"PeriodicalId\":11237,\"journal\":{\"name\":\"Diagnostic Pathology\",\"volume\":\"20 1\",\"pages\":\"63\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-05-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105174/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostic Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13000-025-01667-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13000-025-01667-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}
Complex papillary hyperplasia of the endometrium: an uncommon case report with cytopathological features and diagnostic implications.
Background: Complex papillary hyperplasia of the endometrium (CPHE) is a rare benign lesion with overlapping features of malignancy, posing significant diagnostic challenges. This case highlights the importance of multidisciplinary evaluation to avoid misdiagnosis and overtreatment.
Case presentation: A 49-year-old premenopausal woman presented with irregular vaginal bleeding. Histopathological examination revealed multifocal lesions confined within and on the surface of endometrial polyps, exhibiting complex papillary structures with bland cytology. Immunohistochemistry showed strong ER/PR positivity and retained PTEN expression, while molecular analysis confirmed the absence of high-risk mutations (PTEN, PIK3CA, TP53, CTNNB1).
Conclusions: CPHE requires integration of histopathology, immunohistochemistry, and molecular diagnostics to distinguish it from malignancies. Conservative management is justified in molecularly confirmed cases.
期刊介绍：
Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).
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