子宫内膜微腺体癌临床与病理组织学特征  

Analysis of clinical and pathological characteristics of endometrial microglandular adenocarcinoma

作　　者：李晓红[1] 卿松[2] 王玻玮[2] 刘霞[2] 

机构地区：[1]新疆医科大学第一附属医院妇科,乌鲁木齐830054 [2]新疆医科大学第一附属医院病理科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2014年第7期873-876,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区科技支撑计划(201233142)

摘　　要：目的探讨子宫内膜微腺体癌(microglandular adenocarcinoma,MGA)的临床及病理组织学特征、诊断。方法观察2例微腺体癌的临床及病理学特征,行免疫组织化学染色,同时复习相关文献。结果 2例微腺体癌发病年龄分别为58岁及69岁,以阴道不规律流血就诊,2例活检标本均为微腺体癌,其中1例手术切除标本合并高分化子宫内膜样腺癌。镜下可见标本主要由形态不规则、紧密排列的小腺体构成,细胞核呈轻度不典型。核分裂像少见。腺体间内膜间质少见,见泡沫细胞及大量炎细胞。主要免疫表型:2例上皮均呈P16核(+)、Vim弥漫(+)、Ki-67(10%+)、间质细胞CD10(+)、CD34(-)。结论微腺体癌是一种少见的宫内膜黏液腺癌,恶性程度低,预后较好,通过免疫组织化学染色及组织学形态学特点与宫颈黏膜的微腺体增生(microglandular hyperplasia,MGH)、宫颈粘液腺癌鉴别。Objective To investigate clinical and histopathological features, dignosis and differential diagnosis of the endometrium microglandular carcinoma （MGA）. Methods The clinical and pathological features of microglandular carcinoma in 2 patients were observed. Immunohistochemical staining and literature review were also used. Results In 2 cases, the average age of micro gland carcinoma is 63.5 years. Ciinical manifestation is vaginal irregular bleeding. Both cases are diagnosed as microglandular carcinoma by biopsy. One of the cases had a combined well differentiated uterine endometrioid carcinoma. Endoscope is mainly composed of irregular shape, closely spaced small glands, and glandular cells is mild atypical. Mitosis is rarely observed. The endometrial stromal between glands is rare, but foam cells and Inflammatory cells are much observed. The main immune phenotype： in 2 cases were P16 nuclear （＋）, Vim diffuse （＋）, Ki-67 （10% ＋）, interstitial cells ： CD10 （＋）, CD34 （-）. Conclusion The micro gland carcinoma is a rare endometrial adenocarcinoma. It is low malignant, and prognosis is good. It can be differentiated from cervical microglandular hyperplasia （MGH） and cervical mucus gland carcinoma by immunohistochemistry and morphological characteristics.

关 键 词：微腺体癌 诊断 鉴别诊断 预后 免疫组织化学 

分 类 号：R365[医药卫生—病理学]