子宫和卵巢混合性Mülerian肿瘤的临床病理分析  

Clinicopathologic analysis of mixed Mülerian tumor of uterus and ovary

作　　者：朱芳恒[1] 

机构地区：[1]河南省新乡市中心医院病理科,河南新乡453000

出　　处：《中国医药导报》2010年第23期98-100,共3页China Medical Herald

摘　　要：目的:探讨子宫和卵巢的混合性Mülerian肿瘤(mixed mulerian tumor,MMT)的临床病理特征、生物学行为及预后。方法:对1例子宫和1例卵巢的MMT行HE、免疫组化染色观察,并复习文献。结果:2例患者分别表现为阴道不规则出血和卵巢囊实性包块。大体上分别为宫腔息肉状及壁间浸润性类圆形肿块和卵巢囊实性包块。镜下,例1呈Mülerian腺肉瘤(mülerian adenosarcoma,MA)伴肉瘤过度生长(mülerian adenosarcoma of the uterus withs arcoma-tous overgrowth,MASO),例2呈恶性混合性Mülerian肿瘤(malignant mixedmülerian tumor,MMMT)。免疫组化显示,上皮成分CK和EMA表达阳性,肉瘤成分Vimentin阳性,例1CD99弱阳性。D56、Inhibin-α、HMB45、S-100、Desmin、MyoD1、CD10、SMA、CD45均呈阴性。2例均行子宫全切术+淋巴结清扫+化疗,随访例1于术后9个月、例2于术后13个月病死于肿瘤。结论:MMT是一种相对少见的女性生殖系统肿瘤,临床行为范围从良性(腺纤维瘤、腺肌瘤)到高度恶性(MMMT),正确诊断该类肿瘤对判断预后尤为重要。Objective:To investigate clinicopathological features,biological behavior and prognosis of mixed Mülerian tumor (MMT) of uterine and ovarian.Methods:Immunohistochemical staining and histopathologic observation were analyzed in 1 each case of uterine and ovarian and review of the literature.Results:The patients presented with abnormal vaginal bleeding and ovarian cystic mass,respectively.Cross examination of uterine and ovarian revealed polypoid and intramural invasive uterine round mass and ovarian cystic mass.Microscope,Case 1 was showed Mülerian adenosarcoma (MA)of the uterus with sarcomatous overgrowth (MASO);Case 2 was showed malignant mixed Mülerian tumor(MMMT).Immunohistochemistry showed the positive expression of epithelial components for CK and EMA,sarcoma component for Vimentin,weakly positive for CD99 in case 1.but CD56,Inhibin-α,HMB45,S-100,Desmin,MyoD1,CD10,SMA,CD45 was negative.Two patients underwent hysterectomy + lymph node dissection + chemotherapy,Case 1and 2 was followed up after 9and13 months,died of disease all.Conclusion:MMT is relatively rare cancer of female reproductive system,clinical behavior ranging from benign (adenofibroma,adenomyoma) to highly malignant (MMMT),the correct diagnosis of such tumors is particularly important in judging the prognosis.

关 键 词：子宫 卵巢 Mülerian腺肉瘤 恶性混合性Mülerian肿瘤 预后 

分 类 号：R737.33[医药卫生—肿瘤]