卵巢子宫内膜样间质肉瘤的临床病理学观察  

Clinincopathologic features of primary endometrioid stromal sarcoma of the ovary

作　　者：汪虹[1] 徐久元 

机构地区：[1]湖北省黄冈市中医医院病理科,438000 [2]黄冈职院技术学院病理教研室

出　　处：《中国实用医刊》2015年第11期76-78,共3页Chinese Journal of Practical Medicine

基　　金：黄冈职院技术学院研究计划项目（2011C2022130）

摘　　要：目的探讨卵巢子宫内膜样间质肉瘤的临床病理特点、免疫组织化学表现及鉴别诊断。方法收集2004年至2013年5例卵巢子宫内膜样间质肉瘤的临床病理及随访资料，进行光镜观察及免疫组织化学染色，并对相关文献进行复习。结果5例患者发病年龄52～70岁，平均58．1岁。单侧卵巢4例（3例右侧，1例左侧），双侧1例。病变大体表现为实性结节（4例）及囊实性肿块（1例），肿块大小1．5—6．0cm，平均3．2cm，实性区域切面灰黄，其中1例伴有明显的出血，囊实性肿块中的囊腔内见血性物。镜下见弥漫生长的圆形或卵圆形小细胞包绕细网状小动脉呈纤维瘤样、席纹状或结节状排列，其中1例呈不显著玻璃样变性，另1例可见平滑肌样分化，2例可见泡沫样细胞。这些病例均细胞异型性较小，核分裂像1～6／10HPF。5例均可见卵巢子宫内膜异位。免疫组织化学：CD10阳性5例，PR阳性4例，S—100阳性3例，CD99阳性3例。3例患者有随访资料，2例失访。结论原发于卵巢的子宫内膜样间质肉瘤是一种罕见的卵巢肿瘤，具有与子宫内子宫内膜间质肉瘤相似的病理组织学特点及免疫组织化学结果，诊断需谨慎。Objective To study the clinicopathologic features, immunophenotype and differential diagnosis of endometrioid stromal sarcoma of the ovary. Methods Clinicopathologic and follow-up data of five cases of endometrioid stromal sarcoma of the ovary from 2004 to 2013 were collected and reviewed. Immunohistochemical staining was performed. Results Five patients＇ age ranged from 52 to 70 years （ average 58.1 years）. The tumors were unilateral in 4 cases （3 cases of right side, 1 case of left side） and bilateral in 1 ease. The masses were solid（4 cases） ,solid and cystic（ 1 case） , ranged from 1.5 to 6.0（mean 3.2）em. The solid areas typically had a tan-yellow cut surface, with areas of hemorrhage noted in 1 case. Blood was present in the cyst lumens. On microscopic examination, the predominant pattern was a diffuse growth of small round or oval cells wih interspersed arterioles. Fibromatous, nodular and storiform growth could be observed, unconspicuous hyaline plaques was present in 1 case. Smooth muscle differentiation was seen in 1 case. Foam cells were present in 2 cases. The tumors showed minimal cytologic atypia. The mitotic index ranged from 1 to 6/10 high-power fiel.ds（HPF）. Ovarian endometriosis was associated with the tumor in all 5 cases. Immunhistoehemical study showed that all of the 5 cases were positive for CD10. Four cases expressed PR. S-100 and CD99 could be detected in 3 cases. Follow-up information was available for 3 patients, 2 patients were lost to follow-up. Conclusions Primary endometrioid stromal sarcoma of the ovary is a rare ovary tumor. Its histologic features and immunohistochemical results are similar to uterine endometrial st.romal sarcoma. The diagnosis shoule be made cautiously given its rarity.

关 键 词：卵巢 子宫内膜样间质肉瘤 鉴别诊断 

分 类 号：R737.33[医药卫生—肿瘤]