子宫奇异型平滑肌瘤20例临床病理分析  

Clinicopathologic Analysis of 20 Cases with Bizarre Leiomyoma of Uterine

作　　者：杜维[1] 王黎[2] 聂长庆[1] 杨利民[1] 黄丽芳[1] 

机构地区：[1]湖南省常德市第一人民医院病理科,湖南常德415003 [2]湖南省常德市第一人民医院妇产科,湖南常德415003

出　　处：《医学临床研究》2010年第10期1863-1865,共3页Journal of Clinical Research

摘　　要：【目的】探讨子宫奇异型平滑肌瘤（BLU）的临床病理学特征。【方法】对2003年1月至2010年1月收治的BLU20例手术切除组织标本，采用镜下观察与免疫组化的方法，分析其组织病理学特点。【结果】镜下部分或全部胞核奇异，双核或多核易见，核内多见1至数个较大红染包涵体样物，核分裂象0～2／10高倍视野（HPF）。免疫组织化学示20例α-平滑肌肌动蛋白（SMA）、孕激素受体（PR）均（＋），4例p53蛋白（p53）（＋），3例雌激素受体（ER）（＋），Ki67蛋白（Ki-67）计数约1％～3％。经随访6个月～7年，无复发病例。【结论】BLU虽形态奇异，但属良性肿瘤，本组形态学变化与外源性孕酮药物无关，与妊娠关系应予以关注，应与平滑肌肉瘤（LMS）、恶性潜能待定平滑肌瘤（STUMP）和出血性富于细胞型平滑肌瘤进行鉴别。[Objective] To investigate the clinicopathologic features of bizarre leiomyoma of uterine （BLU）. [Methods] Twenty cases of BLU were selected while these cases were treated during January 2003 to January 2010. The histopathologic features of BLU were investigated by light microscopy and immunohistochemistry （IHC） method. [Results]Light microscopy showed that a part or all of cell nuclei were bizarre and double or multiple nuclei were frequently seen in which rather big and reddish-staining inclusion bodies were obtained, and the mitotic figures were 0 - 2/10 high power field（HPF）. Immunohistochemistry showed that smooth muscle actin（SMA） and progesterone receptor（PR） were positive in 20 cases, and p53 protein was positive in 4 cases and estrogen receptor（ER） was positive in 3 cases. Ki-67 index was about 1% -3%. Fol lowup from 6 months- 7 years showed that no recurrence was found. [Conclusion] BLU belongs to benign tumor, although its shape is bizarre. In this group, the morphological changes are not related with exogenous progesterone, but their relationship with pregnancy should be paid attention to. BLU also should be distinguished form leiomyosarcoma（LMS）, undetermined potential malignant leiomyoma（STUMP） and hemorrhagic cellular leiomyoma.

关 键 词：平滑肌瘤/病理学 子宫肿瘤/病理学 

分 类 号：R737.33[医药卫生—肿瘤]