伴有支持细胞样结构的子宫内膜样癌临床病理观察  

Sertoliform variant of endometrial carcinoma: report of a case and review of literature

作　　者：王利群[1] 王昀[1] 马亚琪[1] 宋欣[1] 钱薇[2] 刘爱军[1] 

机构地区：[1]解放军总医院病理科,北京100853 [2]西安市第四医院病理科,西安710004

出　　处：《诊断病理学杂志》2016年第4期252-254,共3页Chinese Journal of Diagnostic Pathology

基　　金：解放军总医院科技创新基金(13KM42)

摘　　要：目的探讨伴有支持细胞样结构的子宫内膜样癌的临床病理特点、免疫组化及诊断与鉴别诊断。方法观察1例伴支持细胞样结构的子宫内膜样癌的组织学形态及免疫组化特点,并复习相关文献,综合分析其临床病理特征。结果伴有支持细胞样结构的子宫内膜样癌由支持细胞瘤样结构和经典型子宫内膜样癌组成,部分肿瘤细胞成巢状或索状排列,其间可见中空的小管状结构,类似卵巢支持细胞肿瘤的组织学形态。免疫组化显示肿瘤细胞CK、ER和PR(+),CD99灶状(+),Ki-67阳性细胞数<5%,而a-Inhibin、Cg A、Syn和CD56均呈(-)。结论伴有支持细胞样结构的子宫内膜样癌是罕见的子宫内膜样腺癌的组织学亚型,与卵巢的支持细胞瘤易混淆,应充分取材,仔细寻找镜下经典的子宫内膜样腺癌的结构,并结合免疫组化与子宫性索样肿瘤等进行鉴别。Objective To investigate the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of Sertoliform variant of endometrioid carcinoma. Methods One case of Sertoliform variant of endometrioid carcinoma was studied by HE and immunohistochemical staining and the literatures were reviewed. Results Microscopically,the tumor was composed of patterns resembling ovarian Sertoli cell tumors,which were mixed with solid sheets or some tubular structures,and typical morphology of endometrioid adenocarcinoma. Immunohistochemical staining demonstrated that the tumor cells were diffusely positive for CK,ER and PR; CD99 was focally positive,while negative for a-inhibin,Cg A,Syn and CD56. Conclusions Sertoliform variant of endometrioid carcinoma is the most rare type among the endometrioid carcinoma. Morphologically,Sertoliform variant of endometrioid carcinoma is easily confused with ovarian Sertoli cell tumor. To carefully observe the mass, take enough tissue samples, seek the clue of classical endometrioid adenocarcinoma and employ the necessary immunohistochemical staining are very useful to reach a correct diagnosis.

关 键 词：子宫肿瘤 支持细胞样 子宫内膜样癌 

分 类 号：R737.33[医药卫生—肿瘤]