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中国癌症防治杂志 ›› 2016, Vol. 8 ›› Issue (1): 44-47.doi: 10.3969/j.issn.1674-5671.2016.01.10

• 临床经验 • 上一篇    下一篇

低级别子宫内膜间质肉瘤8例临床病理分析

  

  1. 江苏省宝应县人民医院病理科;江苏省扬州市第一人民医院病理科
  • 出版日期:2016-02-25 发布日期:2016-03-11

Low-grade endometrial stromal sarcoma: clinicopathology of 8 cases

  • Online:2016-02-25 Published:2016-03-11

摘要:

目的 探讨低级别子宫内膜间质肉瘤(low-grade endometrial stromal sarcoma,LGESS)的临床病理学特征、诊断、鉴别诊断及预后。方法 回顾性分析8例LGESS患者临床病理资料,并进行随访。结果 8例患者平均年龄46岁。肿瘤直径1~6 cm,平均5 cm。肿瘤位于子宫内6例,临床表现为阴道不规则出血;肿瘤位于子宫外2例,表现为下腹部肿块。镜下由类似子宫内膜增生期间质细胞构成,呈卵圆形或短梭形,在螺旋状小血管周围呈同心圆样排列,呈舌状浸润性生长。免疫组化检测显示肿瘤细胞CD10均呈弥漫强阳性表达,PR均阳性, ER阳性7例,SMA、desmin局灶阳性1例, Inhibin局灶阳性1例。8例均获访,无死亡病例。结论 低级别子宫内膜间质肉瘤确诊主要依靠组织病理学,需免疫组织化学辅助综合分析,CD10、ER、PR可作为LGESS鉴别诊断的重要标志物。

关键词: 子宫肿瘤, 子宫内膜间质肉瘤, 临床病理, 免疫组织化学, 鉴别诊断

Abstract:

Objective To investigate the clinical and pathological features,diagnosis,differential diagnosis and prognosis of low-grade endometrial stromal sarcoma(LGESS). Methods Data on clinicopathology, immunohistochemical detection and follow-up of 8 patients with low-grade endometrial stromal sarcoma were reviewed. Results Patients were aged 36-53 years (average, 46 years);two had menopause. Tumor diameter was 1-6 cm (average,5 cm). Microscopy revealed endometrial hyperplasia and stromal cells with a short spindle or oval shape,arranged spirally in concentric circles around the small blood vessels. Invasive growth was observed on the tongue. Immunohistochemistry showed strong,diffuse expression of ER,CD10, and PR in seven cases. One patient was focal positive for SMA and desmin foci. One patient was positive for inhibin foci. All 8 cases were fol-lowed up with no deaths. Conclusion LGESS can be diagnosed based on histopathology and immunohistochemistry. CD10,ER, and PR may be useful markers for differential diagnosis.

Key words: Uterine neoplasms, Endometrial stromal sarcoma, Clinicopathology, Immunohistochemistry, Differential diagnosis