低度恶性子宫内膜间质肉瘤临床病理特征及误诊原因探析  

The misdiagnosis and clinicopathologic features analysis of low- grade endometrial stromal sarcoma

作　　者：仰晨 

机构地区：[1]南京中医药大学附属医院(江苏省中医院)妇科,江苏南京210029

出　　处：《现代肿瘤医学》2015年第11期1568-1570,共3页Journal of Modern Oncology

摘　　要：目的:探讨低度恶性子宫内膜间质肉瘤(LGESS)的临床病理特征,提高LGESS早期诊断率,以确定手术范围,避免二次手术。方法:对2010年4月至2011年4月我院收治的2例LGESS病例临床及病理资料进行回顾性分析,结合相关文献报道。结果:低度恶性子宫内膜间质肉瘤临床表现为阴道不规则出血,月经过多或绝经后阴道流血、下腹痛,偶尔触及包块。HE染色见肿瘤细胞类似增生期子宫内膜间质细胞,螺旋小血管多见,免疫组化染色2例患者肿瘤细胞CD10、Vimentin、ER、PR均(+)。结论:低度恶性子宫内膜间质肉瘤临床少见,易误诊,确诊主要依靠组织病理学和免疫组织化学。本病预后较好,术前诊断性刮宫是必要的,术中疑有恶性应送快速冰冻病理检查,采用全子宫及双附件切除,辅以化疗者疗效更好。Objective：To investigate the clinical and pathological features of low-grade endometrial stromal sar-coma（ LGESS）,to improve the rate of the diagnosis of LGESS,determine the operable range,avoid the second-opera-tion. Methods：Two cases of LGESS were analyzed by means of reviewing the history records from April,2010 to April 2011 in our hospital and connecting the correlative report. Results：The main clinical symptoms of LGESS were irregu-lar vaginal bleeding,hypomenorrhea or postmenopausal,hypogastric pain,and occasionally touching a mass. The tumor cell resembled the endometrial stromal cell of proliferation phase on HE staining. There were a lot of blood vessels just like the spiral in the tumors. Two cases were positive for CD10,ER and PR by immunohistochemical findings. Conclu/sion：LGESS is very rare and easy to misdiagnosis,the diagnosis relies mainly on histopathological and immunohisto-chemical findings. The prognosis of LGESS is better. It is necessary of diagnostic curettage before operating. In operat-ing if we doubt sarcoma,we must rapid do histopathological examination. The curative effect of annexectomy and chemical therapy is better.

关 键 词：子宫内膜间质肉瘤 临床病理特征 误诊 

分 类 号：R737.33[医药卫生—肿瘤]