目的　探索鉴别子宫高度富于细胞平滑肌瘤与子宫内膜间质肿瘤的形态和免疫组织化学特点及其在鉴别诊断中的意义。方法　采用光镜观察和免疫组织化学EnVision法染色对 2 0例子宫高度富于细胞平滑肌瘤、2 1例内膜间质肿瘤和 1例间质肌瘤进行组织病理学分析。结果　高度富于细胞平滑肌瘤肿瘤细胞致密 ,细胞呈圆形、梭形 ,胞质少 ,与邻近的正常肌壁平滑肌细胞有移行。所有病例都可见到成束分布的肿瘤细胞灶。大的厚壁血管明显可见 ,部分病例中可见裂隙。子宫内膜间质肿瘤肿瘤细胞则与增生期子宫内膜的间质细胞非常相似 ,螺旋状小动脉散布其间。 2 0例低度恶性间质肉瘤肿瘤组织呈舌状侵入邻近肌壁。免疫组织化学显示高度富于细胞平滑肌瘤h caldesmon、calponin、CD10、结蛋白及平滑肌肌动蛋白 (SMA)的阳性率分别为 80 0 % (16 / 2 0 )、10 0 %(2 0 / 2 0 )、0 (0 / 2 0 )、95 0 % (19/ 2 0 )及 10 0 % (2 0 / 2 0 ) ,而子宫内膜间质肿瘤相应的阳性率则为 4 7% (1/2 1)、2 3 8% (5 / 2 1)、6 6 7% (14/ 2 1)、2 3 8% (5 / 2 1)及 19 0 % (4 / 2 1) ,这些抗体在两组肿瘤间的表达差异有显著性 (P =0 0 0 1)。结论　子宫高度富于细胞平滑肌瘤具有特殊形态特点 ,免疫组织化学h caldesmon、calponin、CD10、结? Objective To explore the morphological and immunohistochemical features of differentiated uterine leiomyoma and endometrial stromal tumors and their significance in the differential diagnosis. Methods Histopathological analysis of 20 cases of uterine leiomyoma, 21 cases of endometrial stromal tumor and 1 case of interstitial fibroids were performed by light microscopy and immunohistochemical EnVision staining. Results Highly rich in leukama leukemia tumor cells dense, round cells, fusiform, less cytoplasm, and adjacent normal muscle smooth muscle cell migration. All cases can be seen bundled distribution of tumor cell foci. Large thick-walled blood vessels obviously visible, in some cases visible cracks. Endometrial stromal tumor tumor cells and proliferative endometrial stromal cells are very similar to the spiral artery dissemination. Tumors in 20 cases of low grade malignant stromal sarcoma showed tongue-like invasion into the adjacent muscle wall. Immunohistochemistry showed that the positive rates of hcaldesmon, calponin, CD10, desmin and smooth muscle actin (SMA) were 80% (16/20) and 100% (20% 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1/2 1%, 2 3 8% 5 1/2, 6 6 7% 14 3/2 1, 2 3 8% 5 1/2 and 19 0% 4/21, these The difference of antibody expression in the two groups of tumors was significant (P = 0 0 0 1). Conclusion The uterus is rich in leukama leiomyoma with special morphological characteristics, immunohistochemistry h caldesmon, calponin, CD10,