子宫内膜间质结节临床病理及免疫表型分析  

Analysis of Clinicopathologic Characteristic and Immunophenotype of Endometrial Stromal Nodule

作　　者：杨奇[1] 许跃[2] 

机构地区：[1]镇江市第二人民医院病理科,江苏镇江212001 [2]镇江市第四人民医院病理科,江苏镇江212001

出　　处：《中外医疗》2015年第33期75-77,92,共4页China & Foreign Medical Treatment

摘　　要：目的探讨子宫内膜间质结节(ESN)的临床病理特点及免疫表型,以提高对其诊断的准确性。方法分析该中心2008年1月—2014年12月收治的经病理确诊为子宫内膜间质结节患者4例,分析其临床资料、组织学特征及免疫表型,并复习相关文献。结果 3例患者多因为阴道不规则出血或月经量过多行超声检查提示子宫肌瘤,1例因阴道不规则出血诊刮提示子宫内膜间质肿瘤,平均年龄48岁。巨检显示灰黄色界限清楚的结节样肿块,切面质地细腻均匀。镜检,肿瘤细胞由类似于增生期的子宫内膜间质细胞组成,细胞卵圆形,细胞一致,肿瘤边界清晰。免疫组化4例均显示CD10、ER、PR阳性,其中两例灶性表达SMA,1例局灶表达Des,H-caldesmon均阴性,Ki-67均小于1%。结论子宫内膜间质结节(ESN)是子宫内膜间质肿瘤中最为少见的一种,其临床生物性行为表现为良性,预后良好。手术前明确诊断困难,根据病理组织学检查和免疫表型可以得出正确的诊断。Objective To investigate the clinicopathological characteristic and immunophenotype of endometrial stromal nodule （ESN） to improve the diagnosis of ESN. Methods 4 patients who were confirmed with ESN by Pathologic diagnosis in out center from Jan 2008 to Dec 2014 were analyzed. Their clinical data, histological characteristics, immunophenotype were analyzed, and the related literature were reviewed. Results 3 patients who suffered from irregular vaginal bleeding or hypermenorrhea underwent ultrasonic inspection, and the result showed that they were with hysteromyoma; 1 patient who suffered from irregular vaginal bleeding underwent diagnostic curettage, and the results showed that they were with endome-trial stromal neoplasms. The average age of the patients was 48 years old. Gross examination showed that there were well-demarcated nodular masses with color of grayish yellow, and its section showed an even and smooth texture. Microscopic ex-amination showed that tumor cell was consisted of cell which was approximately the same as proliferative endometrial stro-mal cell, all of them were ovate in appearance, and the tumor showed sharply defined edges. Immunohistochemistry showed that out of the 4 patients who were negative for CD10, ER, PR, 2 were focal positive for SMA, 1 was focal positive for SMA, all the 4 patients were negative for H-caldesmon, and all of their Ki-67 were less than 1%. Conclusion ESN are rare in endometrial stromal neoplasms, and it shows good clinical and biological behaviors and good prognosis. If the difficulty in diagnosing this disease is made clear before operation, histopathologic examination and immunophenotype can produce good diagnostic effect.

关 键 词：子宫内膜间质肿瘤 子宫内膜间质结节 免疫组化 

分 类 号：R5[医药卫生—内科学]