子宫静脉内平滑肌瘤病临床病理观察  

Clinicopathologic observation of intravenous leiomyomatosis in uterus

作　　者：梁华[1] 宫惠琳[1] 张冠军[1] 张娇[1] 杨喆[1] 

机构地区：[1]西安交通大学第一附属医院病理科,陕西西安710061

出　　处：《中国妇幼健康研究》2015年第4期877-880,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨子宫静脉内平滑肌瘤病(IVL)的临床病理、免疫表型及生物学行为特点。方法回顾分析在西安交通大学第一附属医院就诊的3例IVL的临床及病理资料,利用免疫组化方法检测其免疫表型特征。结果术前无确诊病例,1例行全子宫切除术,2例行全子宫加双附件切除术。肉眼呈多结节状或蠕虫样的子宫肌层生长方式,镜下见良性的平滑肌瘤出现在有内皮细胞衬覆的静脉管腔内。免疫组化结果脉管内、外肿瘤细胞Vimtin、Desmin、平滑肌肌动蛋白(SMA)、雌激素受体(ER)、孕激素受体(PR)阳性,脉管内皮细胞CD34、CD31表达阳性。结论 IVL是一类表现为良性却具有恶性肿瘤生物学特性的罕见肿瘤,有远期复发倾向。术前诊断率低,确诊主要依靠病理检查,术后需长期密切随访。Objective To study the clinicopathologic features, immunophenotyping and biologic behavior of intravenous leiomyomatosis （ IVL） in uterus.Methods Clinicopathologic features of three cases of IVL treated in the First Affiliated Hospital of Xi ＇an Jiaotong University were reviewed and their immunophenotyping was analyzed with immunohistochemical method.Results The patients were not confirmed before surgery. Total hysterectomy was performed in 1 case and total abdominal hysterectomy with unilateral salping-oophorectomy or bilateral fallopian tube were performed in the other 2 cases.Nodular or wormlike growing style was found in myometrium by naked eyes.Benign smooth muscle cell tumor appeared in venous vessel lumen covered with endothelial cells.Immunohistochemical study showed that the intravascular and extravascular tumor cells were positive for Vimtin, Desmin, SMA, ER and PR.The endothelium of vessels were positive for CD34 and CD31.Conclusion IVL is a rare neoplasm characterized by benign smooth muscle growing within veins and relapse in far future but with malignant behavior.The preoperative diagnostic rate is low, and the confirm diagnosis mainly depends on pathological examination.Long-term close follow-up is needed.

关 键 词：子宫肿瘤 静脉内平滑肌瘤病 多发性平滑肌瘤 病理 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]