子宫内膜样癌伴黏液乳头状化生3例临床病理观察  

Clinical and pathology observation of 3 cases of endometrioid carcinoma with papillary mucinous metaplasia

作　　者：赵丽娜 张荣辉 黄亚冰[1] 严丹丹 袁静萍[1] 钱红[2] Zhao Lina;Zhang Ronghui;Huang Yabing;Yan Dandan;Yuan Jingping;Qian Hong(Department of Pathology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Pathology,Affiliated Nanhua Hospital,University of South China,Hengyang 421002,China;Department of Pathology,Wuchang Hospital,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院病理科,武汉430060 [2]南华大学附属南华医院病理科,衡阳421002 [3]武汉市武昌医院病理科,武汉430060

出　　处：《中国组织化学与细胞化学杂志》2024年第5期461-465,共5页Chinese Journal of Histochemistry and Cytochemistry

基　　金：武汉市科技计划项目(2017060201010172);武汉大学人民医院引导基金(RMYD2018M27);武汉科技大学,职业危害识别与控制湖北省重点实验室(OHIC2021Z01);武汉市卫生健康科研基金资助(WX21Q57)。

摘　　要：目的探讨子宫内膜样癌伴黏液乳头状化生的临床病理特征、诊断及鉴别诊断方法。方法收集我院3例子宫内膜样癌伴黏液乳头状化生病例,分析其临床病理特征、组织学形态、免疫组化表型及鉴别诊断要点。结果子宫内膜样癌伴黏液乳头状化生主要发生在子宫内膜表面上皮,少部分发生在子宫内膜腺体;黏液化生细胞质内富含黏液的柱状细胞,类似宫颈管腺上皮,呈复杂分支的乳头状增生;化生区域免疫组化ER、PR表达下降,Vim表达缺失,可以出现P16高表达及CEA灶状阳性。结论子宫内膜样癌伴黏液乳头状化生较少见,易误诊为子宫内膜黏液腺癌或宫颈黏液腺癌,有时也要与低级别浆液性癌相鉴别;需仔细观察并综合分析。Objective To investigate the clinicopathologic features,diagnosis and differential diagnosis of endometrioid carcinoma with mucopapillary metaplasia.Methods Three cases of endometrioid carcinoma with mucopapillary metaplasia were collected and their clinicopathological features,histological morphology,immunohistochemical phenotype and differential diagnosis were analyzed.Results Endometrioid carcinoma with mucopapillary metaplasia mainly occurred in the surface epithelium of endometrium,and a few of them occurred in endometrial glands,the expression of ER and PR was decreased in the metaplastic area,and the expression of Vim was absent.P16 was over-expressed and CEA was positive in the metaplastic area.Conclusion Endometrioid carcinoma with mucopapillary metaplasia is rare and easy to be misdiagnosed as endometrium mucinous adenocarcinoma or cervical mucinous adenocarcinoma.Sometimes it is also necessary to differentiate it from low-grade serous cancer;making the correct diagnosis requires the careful observation and comprehensive analysis.

关 键 词：内膜样癌 乳头状增生 黏液化生 

分 类 号：R737.33[医药卫生—肿瘤]