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目的 :探讨宫内膜活检或刮出物诊断子宫内膜间质肉瘤的标准和鉴别诊断注意事项。方法 :对 9例临床和病理资料完整并经宫内膜活检或刮出物中确诊的子宫内膜间质肉瘤 ,对照其随后进行的子宫切除标本的蜡块 ,再次常规制片 ,HE染色 ,光镜进行对比观察。结果 :9例宫内膜活检或刮宫标本中 ,有 6例分化良好 ,酷似子宫内膜增生过长时的间质细胞。有 3例分化差者 ,其中 2例酷似恶性淋巴瘤 ,1例酷似多形性肉瘤。 9例均见簇状分布的子宫内膜螺旋小动脉样的小血管分布 ,2例见瘤组织沿淋巴管和突入淋巴管内生长及小片平滑肌组织的肌间隙内有小灶状或小片状瘤组织分布。 9例子宫切除标本的对比观察 ,进一步证实了上述特征对宫内膜活检或刮出物确诊子宫内膜间质肉瘤的价值。结论 :只要严格掌握宫内膜活检或刮出物中诊断子宫内膜间质肉瘤的形态学特征和注意鉴别诊断事项 ,该诊断方法是切实可行的
Objective: To investigate the criteria of endometrial biopsy or diagnosis of endometrial stromal sarcoma and differential diagnosis. Methods: Nine cases of endometrial stromal sarcoma diagnosed by endometrial biopsy or scraping were completed and compared with the paraffin-embedded sections of the hysterectomy specimens which were followed by routine preparation and HE staining. Light microscope for comparison. Results: Nine cases of endometrial biopsy or curettage specimens, there are 6 cases of well-differentiated, resembles endometrial hyperplasia of interstitial cells. There were 3 cases of poor differentiation, 2 cases resembled malignant lymphoma, 1 case resembles pleomorphic sarcoma. 9 cases were found in clusters of endometrial spiral arteriole-like distribution of small blood vessels, 2 cases of tumor tissue along the lymphatic vessels and into the lymphatic vessels in the growth and small pieces of smooth muscle tissue within the interstitial small focal or small tumorous tissue distributed. Nine cases of hysterectomy specimens were compared, further confirmed the above characteristics of endometrial biopsy or the diagnosis of endometrial stromal sarcoma value. Conclusions: This diagnostic method is feasible as long as the strict diagnosis of endometrial biopsy or scrapings in the diagnosis of endometrial stromal sarcoma morphological characteristics and attention to differential diagnosis matters