子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状浸润1例  

Micropapillary pattern in endometrioid carcinoma with microcystic,elongated and fragmented pattern invasion:A case report

作　　者：付家驹 周晓莉[2] 顾文贤[2] 高蔚[2] 程羽青[2] FU Jiaju;ZHOU Xiaoli;GU Wenxian;GAO Wei;CHENG Yuqing(Department of Pathology,Changzhou Jintan First People’s Hospital,Changzhou Jiangsu 213200;Department of Pathology,Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University,Changzhou Jiangsu 213003,China)

机构地区：[1]常州市金坛第一人民医院病理科,江苏常州213200 [2]南京医科大学附属常州市第二人民医院病理科,江苏常州213003

出　　处：《临床与病理杂志》2023年第7期1453-1458,共6页Journal of Clinical and Pathological Research

基　　金：常州市科技局海外人才专项(CQ20204036)。

摘　　要：子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。Micropapillary pattern in endometrioid carcinoma with microcystic,elongated and fragmented(MELF)pattern invasion is rare.A 52-year-old female patient with endometrioid carcinoma was admitted to Changzhou No.2 People’s Hospital,and micropapillary pattern was present in the tissues of pathological examination.The micropapillary pattern was composed of clusters or small nests of tumor cells with the surrounding lacunae and obvious atypia but without fibrovascular axes, which was similar to that of invasive micropapillary carcinoma of breast. Immunohistochemically, micropapillary pattern was characterized by outer edge staining of mucin1 and cup-like staining of E-cadherin. MELF pattern invasion can be observed in the tumor invasive front. The tumor infiltrated into the deep layer of muscle. There were vascular carcinoma emboli and a lymph node with occult metastasis in the tumor. The patient received postoperative chemotherapy and radiotherapy, and recovered well. No recurrence or metastasis was observed during 53 months of follow-up. Clinically, such patients have highly aggressive biological behaviors and are prone to be underdiagnosed in daily practice, which should be paid more attention to.

关 键 词：子宫内膜样癌 微乳头 微囊、伸长及碎片状浸润 

分 类 号：R737.33[医药卫生—肿瘤]