阴道上皮样平滑肌瘤的临床病理分析  

Clinicopathology of Vaginal Epithelioid Leiomyoma

作　　者：孙艳花[1] 宋建明[1] 许美权[1] 温文[1] 关弘[1] 

机构地区：[1]广东省深圳市第二人民医院病理科,518035

出　　处：《中国全科医学》2011年第24期2787-2790,共4页Chinese General Practice

基　　金：深圳市科技计划项目--端粒酶在宫颈非典型性不成熟鳞状上皮化生中的表达及意义(200802033)

摘　　要：目的探讨阴道上皮样平滑肌瘤的病理学特征、免疫学表型、鉴别诊断及预后。方法采用免疫组织化学染色和分子原位杂交技术,观察和分析1例阴道上皮样平滑肌瘤患者的病理学特征、hTERT蛋白表达和EBERs基因表达。结果阴道上皮样平滑肌瘤的肿瘤细胞较小,呈上皮样,为圆形、卵圆形,细胞排列呈巢片状或簇状,细胞质弱嗜酸性或呈透明状;细胞核呈圆形、卵圆形,位于细胞中央,核分裂（2~4）个/50HPF,细胞无异型。间质黏液样变、胶原样变明显。肿瘤内可见巨菊形团,巨菊形团中央为嗜伊红的胶原纤维。免疫组织化学：波形蛋白（V imen-tin）、结蛋白（Desm in）、雌激素受体、孕激素受体、hTERT均阳性;原位杂交EBERs基因表达阴性。结论阴道上皮样平滑肌瘤是一种罕见类型肿瘤,倾向于良性,局部手术切除多能治愈。肿瘤细胞hTERT阳性,提示肿瘤的发生可能与端粒酶的激活有一定的相关性。肿瘤细胞EBERs基因阴性表达,提示肿瘤的发生可能与EB病毒感染无关。肿瘤细胞雌激素受体和孕激素受体高表达,说明该肿瘤可能对雌激素、孕激素有比较高的反应性。Objective To explore the clinicopathologicat features, immnophenotype, differential diagnosis and prog nosis of epithelioid leiomyoma of vagina. Methods Immunohistochemical staining and in situ hybrization technique were used to detect the clinicopathological features, human telomerase reverse transcriptase （hTERT） protein expression and EBERs gene ex pression in vaginal epithelioid leiomyoma tissues. Results The tumor was composed of small, round to oval epithelioid cells arranged in nests and clusters. Cytoplasm was faintly eosinophilic or clear. Nuclei were centrally located and round to oval. Mitotic figures were （2 -4） /50 HPF and atypia was not present. Collagenous and myxoid areas were seen in the stroma. Giant rosette - like structures were observed. The centres of these giant rosettes were composed of eosinophilic collagen. Vimentin, Desmin, estrogen receptor, progestogen receptor and hTERT were all positively stained in the tumor in the irmnunohistochemical examina- tion. EBERs were negatively stained in the tumor during the in situ hybridization. Conclusion Epithelioid leiomyoma of vagina is rare and probably benign, which could be cured by local resection. The tumor is hTERT - postive, indicating a correlation be- tween its development and the activation of telomerase. The tumor is EBERs - negative, indicating that no correlations exist between its development and EBV infection. Estrogen receptor and progestogen receptor were strongly positive in the tumor, indica- ting that the tumor is highly reactive to estrogen and progestogen.

关 键 词：阴道肿瘤 平滑肌瘤 上皮样 免疫组织化学 原位杂交 病理状态 体征和症状 

分 类 号：R737.34[医药卫生—肿瘤]