子宫上皮样平滑肌瘤临床病理分析  

A clinicopathological study on uterine epithelioid leiomyoma

作　　者：袁峥[1] 刘秀云[1] 杨红鹰[1] 

机构地区：[1]中国医学科学院肿瘤医院病理科,北京100021

出　　处：《中国肿瘤临床与康复》2011年第1期19-23,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨子宫上皮样平滑肌瘤临床病理特征和生物学特性。方法观察2例子宫上皮样平滑肌瘤的临床、病理组织学及免疫组织化学特点,KRAS基因突变检测分析并复习文献。结果 2例均由胞浆丰富嗜酸的上皮样肿瘤细胞组成。1例体积巨大,大小为20 cm×17 cm×8 cm,镜下未见坏死及核分裂相;1例属多发性子宫平滑肌瘤,其中仅有一个富于细胞,呈上皮样分化,大小为2.5 cm×2.1 cm×1.8 cm,可见核分裂相（3-4个/10HPF）,未见坏死。免疫组织化学：Vimentin、Desmin、Actin、SMA、ER、PR阳性,CD10、MyoD1、S-100、HMB45、AE1/AE3、α-Inhibin、MDM2、p16、p53、CD117阴性;Ki-67标记指数〈2%阳性。KRAS基因检测无突变。分别密切随访18个月及10年,患者预后良好,尚未发现复发及转移。结论子宫上皮样平滑肌瘤临床少见,生物学行为有特殊性,难以定性。明确其诊断标准及生物学行为,对于进一步治疗及预后判断具有重要指导意义。Objective To investigate the clinicopathological and biological features of uterine epithelioid leiomyoma（EL）.Methods Two cases of uterine epithelioid leiomyoma were studied using clinical analysis,histopathology,immunohistochemistry and KRAS mutation detection with review of relevant literature.Results Both of the 2 tumours were composed of epithelioid cells with eosinophilic cytoplasm.One of them had huge size measuring 20×17×8 cm^3 without necrosis and mitotic figures microscopically.Another was cellular measuring 2.5×2.1×1.8 cm^3 without necrosis and showed epithelioid differentiation with mitotic figures（3-4/10HPF） microscopically.Immunohistochemical staining revealed that the tumour cells were positive for vimentin,desmin,actin,SMA,ER,PR and negative for CD10,MyoD1,S-100,HMB45,AE1/AE3,α-Inhibin,MDM2,p16,p53,CD117.The positive tumour cells of Ki-67 label index were both less than 2% in 2 cases.No KRAS point mutation was detected.Both patients showed no recurrence or metastasis until the last follow-up（18 months and 10 years respectively）.Conclusions Uterine epithelioid leiomyoma was an uncommon neoplasm with uncertainly biological features.To clarify the diagnostic criteria and its biological features are most important for effective therapy and judging prognosis.

关 键 词：子宫肿瘤 平滑肌瘤 上皮样 病理学 生物学行为 

分 类 号：R737.33[医药卫生—肿瘤] R730.2[医药卫生—临床医学]