子宫腺瘤样瘤50例临床病理分析  

Uterine adenomatoid tumors:a clinicopathological analysis of 50 cases

作　　者：谭敏华[1] 雷伟华[1] 胡志雄[1] 郭锦辉[1] 陈威[1] 邹绮嫦[1] 邓超桦[1] 欧瑞芬 周泳健 TAN Min-hua;LEI Wei-hua;HU Zhi-xiong;GUO Jin-hui;CHEN Wei;ZOU Qi-chang;DENG Chao-hua;OU Rui-fen;ZHOU Yong-jian(Department of Pathology,the First People Hospital of Zhaoqing,Zhaoqincj 526000,China)

机构地区：[1]肇庆市第一人民医院病理科,广东肇庆526000

出　　处：《诊断病理学杂志》2018年第8期567-570,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨子宫腺瘤样瘤(ATs)组织发生及命名、临床病理特征与鉴别诊断。方法对50例子宫ATs的临床病理资料进行回顾性分析,并结合文献资料复习。结果 50例子宫ATs发生率占同期子宫肿瘤切除标本的1.4%,单纯子宫ATs 14例(28%),伴子宫其他病变36例(72%)。肿瘤多位于子宫浆膜下肌壁间,结节状生长,单发43例(86%),多发7例(14%),肿瘤直径0.5~5 cm,边界清或欠清,无包膜。临床表现及影像学均无特征性。肿物类似平滑肌肿瘤,切面灰白、灰黄色,实性均质,质硬或较软,部分切面湿润,可见大小不一的囊腔,囊内含有黏液。镜下肿瘤组织均由增生平滑肌和上皮样成分组成,上皮样成分形态呈大小不一的腺样、腔隙样、实性巢状、条索状,单个形似浸润性分布于平滑肌束之间,上皮样细胞异型性小或无,未见核分裂象,增生的平滑肌呈束状或编织状排列。18例腔隙内黏液样物阿尔辛蓝染色(+),PAS染色(-)。免疫组化:50例上皮样成分CK、vimentin、HBME-1、CR和D2-40(+),Ki-67阳性指数均<1%。术后随访均无复发或恶变。结论子宫ATs是一种少见的良性肿瘤,起源于间皮,临床及病理检查均不易确诊,免疫组化检查有助于诊断。Objective To investigate the histogenesis and naming of adenomatoid tumors（ ATs）,clinical and pathological features and differential diagnosis.Methods The clinical and pathological data of 50 patients with uterine ATs were retrospectively analyzed and reviewed.Results 50 cases of uterine ATs accounted for 1.4% of uterine tumor resection specimens,and there were 14 cases（ 28.0%） of uterine ATs alone,36 cases（ 72.0%） with other uterine lesions.Tumor mostly in the uterus near the subserosa of the muscle wall,were nodular growth;43 cases（ 86.0%） were single and 7 cases（ 14.0%） were multiple with diameter 0.5 - 5 cm;the border was clear or less clear,without capsule.Clinical manifestations and imaging studies were not characteristic.Generally,it was similar to smooth muscle tumors：gray and gray-yellow on cut surface,solid homogeneous and hard or softer;part of the surface was moist,visible size of the cysts containing mucus.Microscopically,the tumors were composed of hyperplastic smooth muscle and epithelium-like components.Epithelioid components were arranged in adenoid,lacunar-like,solid nest-like,cord-like,single-like infiltration between the smooth muscle bundles;epithelioid cells showed no or less atypia without mitotic figures;hyperplastic smooth muscle was bundled or braided arrangement.18 cases were positive for Alcian blue staining but negative for PAS staining.Immunophenotypically,50 cases of epithelioid cells expressed CK,Vim,HBME-1,CR and D2-40;Ki67 expression was 〈1%.There was no recurrence or malignant transformation after follow-up.Conclusion Uterine ATs is a rare benign tumor,originated in the mesothelium.TAs are not easily diagnosed by clinical and pathological examinations,and immunohistochemistry helps in diagnosis.

关 键 词：子宫肿瘤 腺瘤样瘤 鉴别诊断 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]