摘要
目的:探讨子宫内膜间质肉瘤(ESS)的临床病理特点、诊断及鉴别诊断。方法:回顾性分析15例ESS的临床病理特征、免疫组化检测结果。结果:ESS临床特征为不规则阴道出血、月经过多、下腹痛,偶可触及包块。病理学特征为:10例低级别ESS,瘤细胞呈短梭形,细胞异型较小,伴有较多厚壁血管似"螺旋小动脉",似增殖期子宫内膜间质细胞;3例高级别ESS,瘤细胞异型较大,核分裂像多见;2例未分化肉瘤,瘤细胞异型显著,间质分化不明显,可见坏死。免疫组化染色结果显示:15例均CD10(+),Vimentin(+),4例P53(+),3例ER(+),4例PR(+),4例SMA(+),其余免疫组化标志物如LCA、CD20、CD38、S-100、EMA均阴性。结论:发生于子宫的子宫内膜间质肉瘤较少见,根据病理学特点结合免疫组化表型确诊,需与发生于子宫的平滑肌肉瘤、子宫内膜间质结节等鉴别。
Objective:To investigate the clinicopathological feature as well as the diagnosis and differential diagnosis of endometrial stromal sarcoma(ESS).Methods:The pathological characteristic and immunohistochemical phenotype in 15 cases of endometrial stromal sarcoma were analyzed retrospectively.Results:The clinical symptoms included irregular vaginal bleeding,menorrhagia,hypogastralgia,and even had palpable mass.Pathological diagnoses of 10 cases were low-grade ESS,with lower cell heteromorphism,similar to the proliferation period of endometrial stromal cells;3 cases were high grade ESS,with spindle shape tumor cells and cell atypia.Nuclear karyokinesis can be seen;2 cases of undifferentiated sarcoma,with higher cell heteromorphism.Interstitial differentiation was not obvious,with significant hemorrhagic necrosis.Immunohistochemical staining showed CD10+,vimentin(+)in 15 cases;P53(+),PR(+)and SMA(+)in 4 cases;ER(+)in 3 cases;LCA,CD20,CD38,S-100 and EMA were negative.Conclusion:The endometrial stromal sarcoma is rare,with various morphology and different differentiation.It is easy to be misdiagnosed.The diagnosis of endometrial stromal sarcoma mainly depended on histopathology and results of immunohistochemistry.
作者
蔡凤梅
郅玲然
王卉芳
侯惠莲
Cai Fengmei;Zhi Lingran;Wang Huifang(Department of Pathology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061)
出处
《陕西医学杂志》
CAS
2018年第2期256-258,共3页
Shaanxi Medical Journal
基金
陕西省科技攻关项目(2012K13-02-04)
作者简介
通讯作者:侯惠莲
