弥漫性子宫平滑肌瘤病8例临床病理分析  

Clinical and Pathological Analysis of 8 Cases of Diffuse Uterine Leiomyomatosis

作　　者：林琳[1] 陈素清[1] 刘达宾[1] 刘照贞[1] 陆婷[1] 

机构地区：[1]福建省妇幼保健院,福建福州350001

出　　处：《实用妇产科杂志》2013年第3期218-220,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨弥漫性子宫平滑肌瘤病(DUL)的临床病理特征和诊治情况,以期提高对该病的诊治水平。方法:对2006年11月至2011年10月我院收治的8例经手术后病理检查证实的DUL患者,从临床情况、诊治、病理检查等方面进行回顾性分析。结果:8例患者平均年龄37.75岁。3例经量增多及贫血,4例腹痛,3例无症状。术前被误诊为单发性子宫肌瘤1例、多发性子宫肌瘤5例及子宫腺肌病2例。2例行子宫肌瘤剔除术,6例行全子宫或次全子宫切除术。仅1例见边界欠清的单发结节;余7例均见子宫肌层和(或)宫腔布满或多发结节,其中1例见肌壁间弥漫布满细小瘤样结节。8例病理检查均证实为DUL。结论:DUL临床表现无特殊,术前诊断困难,需术后病理检查证实。病理特点为子宫肌层呈弥漫性结节样增生,宫体全层被大小不等的平滑肌瘤累及,无细胞异型性和异常有丝分裂,无脉管内生长。手术是最主要的治疗方法,多采用全子宫或次全子宫切除术。Objective：To discuss the clinical features and treatment of diffuse uterine leiomyomatosis （dif- fuse uterine leiomyomatosis, DUL ）. Methods ：8 cases of diffuse uterine leiomyomatosis confirmed by I^athol- ogy,from November 2006 to October 2011 in Fujian Provincial Maternity and Child Care Center,were retro- spectively analyzed. Results ：The average age of 8 cases is 37. 75 years. 3 cases presented with menorrha- gia and anemia,and 4 cases presented with abdominal manifestations. 3 cases lacked of clinical symptoms. 8 cases of preoperative patients were all misdiagnosed as single （1 case） or multiple （5 cases） uterine myo- ma,or adenomyosis （3 cases ）before surgery. 2 cases underwent myomectomy, and 6 cases underwent hysterectomy. A single nodule with unclear boundary was only observed in one patient,and in the other sever~ patients, myometrium and/or uterine cavity full of multiple nodules were observed. Diagnoses of DUL of 8 ca- ses were all pathologically confirmed. Conclusions： Diffuse uterine leiomyomatosis is difficult to diagnose preoperative because-of lacking of specific clinical features. Pathological characters ioclude diffuse nodular hyperplasia in myometrium, whole layer of corpus occupied by countless leiomyomas with vary sizes and clear boundary, no cell atypia and abnormal mitosis, and no vascular growth. Surgical treatment is the main treatment strategy, and the classic procedure is hysterectomy.

关 键 词：弥漫性子宫平滑肌瘤病 子宫肌瘤 全子宫切除术 

分 类 号：R737.33[医药卫生—肿瘤]