低度恶性子宫内膜间质肉瘤的临床病理特点  

Clinicopathological features of low - grade endometrial stromal sarcoma

作　　者：邓再兴 

机构地区：[1]浙江省湖州市妇幼保健院病理科,湖州313000

出　　处：《实用肿瘤学杂志》2005年第2期105-108,共4页Practical Oncology Journal

摘　　要：目的探讨低度恶性子宫内膜间质肉瘤(LGESS)的临床及病理特点。方法回顾性分析10例LGESS的临床及病理资料,部分病例辅以免疫组织化学染色。结果患者年龄35-61岁,平均为46.5岁。LGESS临床上多表现为不规则阴道出血。大体类型有宫内型、壁间型、弥漫型及混合型。肿瘤切面呈典型的鱼肉状、淡黄色或部份淡黄色、松软。2例有囊性变。镜下肿瘤细胞类似增殖期子宫内膜间质细胞,螺旋小血管多见。肿瘤细胞呈舌状浸润肌层或弥漫浸润。4例伴有不同程度的平滑肌分化,1例伴有性索样分化。8例获随访2-8年,1例绝经后患者术后4年复发,其余无复发。结论LGESS临床少见,术前诊断困难,预后较好。大体病理检查有其特征性,镜下特点显示多样性,平滑肌分化常见。Objective To investigate the clinical and pathological characteristics of low- grade endo metrial stromal sarcoma (LGESS). Methods Clinical data and pathological characteristics of LGESS were reviewed retrospectively in 10 cases, some of them have been studied by immunohistochemical techniques. Results The patients tanged from 35 to 61 years in age (mean age 46.5 years). Most patients presented with irregular uterine bleeding. Grossly, the tumors revealed intrauterine type, intramural type, diffuse type and mixed type. The tumors were typically fleshy and yellow or at least in part yellow and soft on sectioning. Cystic change was presented in 2 cases. Microscopically, the tumor cell resembled the endometrial stromal cell of proliferation phase and the helical arterioles were often found. The tumor cell presented ligukte - invasion reaching the muscular layer or diffusely infiltrating pattern. Four tumors showed variable degrees of smooth muscle differentiation and sex cord - like differentiation occurred in one. Follow - up in 8 cases, ranged from 2-8 years, revealed one recurrence in postmenopausal case and no recurrence in the rest. Conclusion LGESS is an uncommon tumor in clinic. It is difficult to diagnosze LGESS pre - operation and the prognosis of LGESS was usually better. LGESS has distinct feature grossly and shows diverse morphological feature. Smooth muscle differentiation is common.

关 键 词：低度恶性子宫内膜间质肉瘤 临床病理特点 免疫组织化学染色 子宫内膜间质细胞 不规则阴道出血 平滑肌分化 肿瘤细胞 回顾性分析 性索样分化 病理资料 患者年龄 大体类型 弥漫浸润 不同程度 诊断困难 病理检查 混合型 弥漫型 

分 类 号：R737.33[医药卫生—肿瘤] R735.2[医药卫生—临床医学]