生殖器侵袭性血管黏液瘤的临床及病理分析  

Clinicopathologic analysis of aggressive angiomyxoma in the pelvis and vulva of 8 cases

作　　者：廖秦平[1] 刘朝晖[1] 张岩[1] 何群[2] 

机构地区：[1]北京大学第一医院妇产科,100034 [2]北京大学第一医院病理科,100034

出　　处：《中华妇产科杂志》2002年第6期359-362,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　了解女性生殖器侵袭性血管黏液瘤的组织学来源、临床和病理特点以及治疗方法和预后。方法　回顾性分析 1996年至 2 0 0 0年的 8例女性生殖器侵袭性血管黏液瘤患者的临床病理资料 ,并对其中 7例病理切片进行免疫组织化学 (组化 )染色分析。结果　 6例发生于外阴 ,2例发生于会阴、阴道及盆底。其中 ,2例有病灶局部切除史。发病时间长短不一 ,为 5个月至 2 0年不等。治疗以局部肿物切除为主 ,术后随访 3～ 6 3个月 ,除 1例复发后失访外 ,无一例复发。 7例行免疫组化检测 ,结果显示 ,肿瘤细胞阳性反应为波形蛋白 (vimentin)者 7例、平滑肌肌动蛋白 (smoothmuscleactin ,SMA) 7例、8因子 (factor8,F8) 7例、增殖细胞核抗原 (proliferatingcellnuclearantigen ,PCNA) 4例、雌激素受体 (estrogenreceptor ,ER) 3例、孕激素受体 (progesteronereceptor,PR) 4例 ,S 10 0蛋白及CD68均阴性。结论　侵袭性血管黏液瘤是一种少见的低度恶性的间叶性肿瘤 ,免疫组化提示其肌纤维母细胞或纤维母细胞来源可能性大。主要临床特点有生长缓慢和局部浸润性生长。治疗以手术切除为主 ,虽偶有复发 。Objective To study the clinical and pathologic features of aggressive angiomyxoma (AAM) and its occurrence, treatment and prognosis Methods The 8 cases of AAM were analyzed retrospectively, among which 6 cases in vulva, 2 cases in perineum, vagina and pelvis As well we performad immunohistochemical studies Results The neoplastic cells were at least focally immunoreactive for vimentin (7/7), smooth muscle actin (7/7), factor 8 (7/7), proliferating cell nuclear antigen (4/7), estrogen (3/7) and pregesterone (4/7) receptors All of the examined tumors were negative for S100 protein and cluster designation 68 Conclusions AAM is an uncommon mesenchymal tumor that preferentially involves the pelvic and perineal regions of females In immunohistochemical investigation the neoplastic cells of AAM exhibit fibroblastic and myofibroblastic features They are characterized by slow growth, infiltration of adjacent structures, absence of distant metastases, a tendency to recur locally and a fairly good prognosis Treatment should consist of wide surgical excision, as complete as technically possible

关 键 词：侵袭性血管黏液瘤 AAM 粘液瘤 生殖器肿瘤 免疫组织化学 女性 病理 诊断 治疗 临床分析 

分 类 号：R730.2[医药卫生—肿瘤]