论文部分内容阅读
目的探讨子宫平滑肌瘤伴腺瘤样瘤的临床病理形态特征及鉴别诊断。方法 42例子宫平滑肌瘤伴腺瘤样瘤患者的常规病理组织学和免疫组化检查,并结合相关文献,探讨其临床病理特征。结果 42例患者子宫平滑肌瘤伴腺瘤样瘤中40例苏木素-伊红(HE)形态呈腔隙样或腺样,腔壁衬覆立方或扁平上皮,多数无明显衬覆上皮,部分腔内见黏液样物。2例HE形态表现部分腺腔内见以纤维血管为轴心的乳头,轴心伴纤维化,无微小乳头及二、三级乳头分枝;部分腺腔内见砂粒体。甲状腺转录因子-1(TTF-1)、表面活性蛋白-B(Sp-B)、和免疫组化示:细胞角蛋白(CK)(+),神经特异度钙结合蛋白(CR)(+),间皮细胞抗原(MC)(+),CK7(+),上皮膜抗原(EMA)(-),CK20(-),癌胚抗原(CEA)(-),急性淋巴母细胞共同抗原(CD10)(-),雌激素受体(ER)(-),孕激素受体(PR)平滑肌(+),肌动蛋白(Actin)平滑肌(+),结蛋白(Desmin)平滑肌(+)。手术后随访8个月~7年,均无复发或发生恶变的情况。结论子宫平滑肌瘤伴腺瘤样瘤是良性混合性肿瘤,由肿瘤性平滑肌和间皮组织构成,特殊形态时其诊断需依赖病理组织学及免疫组化检查与癌相鉴别,不同病理学形态其生物学行为均呈现出良性。
Objective To investigate the clinicopathological features and differential diagnosis of leiomyomata with adenoma. Methods The routine histopathological and immunohistochemical examinations of 42 cases of uterine leiomyomas with adenoma-like tumor were studied, and their clinical and pathological features were analyzed with related literatures. Results Forty-two cases of hemangiomatous aneurysm in 42 cases of patients with uterine leiomyomas showed hematoxylin-eosin (HE) morphology as lacunar or adenoid, with luminal walls covered with cubic or squamous epithelium. Most of them had no lining epithelium, See mucus samples inside. 2 cases of HE morphology showed part of the gland lumen to see the fibrovascular axis of the nipple, axis with fibrosis, no tiny nipple and two or three nipple branches; gland cavity seen in part of the glandular cavity. Thyroid transcription factor-1 (TTF-1), surfactant protein B (Sp-B), and immunohistochemistry showed cytokeratin (CK) (MC), CK7 (+), epithelial membrane antigen (EMA) (-), CK20 (-), carcinoembryonic antigen (CEA) (-), estrogen receptor (ER), progesterone receptor (PR) smooth muscle (+), actin smooth muscle (+) and Desmin smooth muscle (+). Follow-up 8 months to 7 years after surgery, no recurrence or malignant transformation. Conclusions Uterine leiomyoma with adenoma is a benign mixed tumor composed of tumorous smooth muscle and mesothelium. The diagnosis of special form depends on histopathology, immunohistochemical examination and differentiation of cancerous phase, Its biological behavior are benign.