子宫恶性中胚叶混合瘤3例临床病理分析  

Clinicopathological features of malignant mixed mesodermal tumor of the uterus: an analysis of three cases

作　　者：夏天 肖秀丽 刘萍 蒋堃 龙汉安 XIA Tian;XIAO Xiuli;LIU Ping;JIANG Kun;LONG Hanan(Department of Pathology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Prov-ince,China;Department of Pathology,the Luzhou People＇s Hospital)

机构地区：[1]西南医科大学附属医院病理科 [2]泸州市人民医院病理科,四川泸州646000

出　　处：《西南医科大学学报》2018年第5期414-417,共4页Journal of Southwest Medical University

基　　金：2013年泸州市政府-泸州医学院联合专项项目;NO.2013LZLY-J28

摘　　要：目的:探讨子宫恶性中胚叶混合瘤的临床病理特征、免疫表型及鉴别诊断。方法:对3例诊断为子宫恶性中胚叶混合瘤患者的临床资料、组织学形态及免疫组化结果进行回顾性分析,并对相关文献进行复习。结果:3例患者其中2例为绝经后患者,1例为未绝经期患者,年龄分别为44岁、64岁、78岁。临床表现为异常阴道排液或出血,伴或不伴下腹或盆腔疼痛。镜下肿瘤均由不同比例的恶性间叶组织及恶性上皮构成。免疫组化表型:3例恶性上皮成分PCK、CK7、ER、PR均(+),CK20(-)。3例间叶性肿瘤成分Vimintin、SMA均(+),其中2例横纹肌肉瘤成分Actin、Desmin、MyoD1、Myogenin(+),1例软骨肉瘤成分S-100(+)。结论:子宫恶性中胚叶混合瘤是罕见的高度恶性肿瘤,患者多为中老年女性,其临床表现无特异性,诊断主要依靠病理学检查,故提高病理医师对本病的认识,对累积资料,避免临床误诊、漏诊具有重要的价值。Objective To investigate the clinicopathological features, immunophenotype, and differential diagno-sis of malignant mixed mesodermal tumor of the uterus. Methods： A retrospective analysis was performed for theclinical data, histology, and immunohistochemical results of three patients who were diagnosed with malignant mixedmesodermal tumor of the uterus, and related literature was reviewed. Results： Of all three patients, two were post-menopausal and one was non-menopausal, with an age of 78, 64, and 44 years, respectively. Clinical manifestationsincluded abnormal vaginal discharge or bleeding, with or without lower abdominal pain or pelvic pain. The tumorswere composed of different proportions of malignant mesenchymal tissue and malignant epithelium. As for immuno-phenotype, the malignant epithelium in all three patients was positive for PCK, CK7, ER, and PR and negative forCK20. Mesenchymal tumor in all three patients was positive for Vimintin and SMA; rhabdomyosarcoma in two pa-tients was positive for Actin, Desmin, MyoD1, and Myogenin; chondrosarcoma in one patient was positive for S-100.Conclusion： Malignant mixed mesodermal tumor of the uterus is a rare and highly malignant tumor, which is com-monly seen in middle-aged and elderly women. The clinical manifestations of this disease are not specific, and diag-nosis mainly relies on pathological examination. Therefore, it is very important to deepen the understanding of thisdisease, in order to avoid misdiagnosis and missed diagnosis in clinical practice.

关 键 词：子宫 恶性中胚叶混合瘤 临床病理特征 

分 类 号：R737.33[医药卫生—肿瘤]