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目的探讨子宫内膜息肉样腺肌瘤的临床病理特征、诊断及鉴别诊断。方法对8例子宫内膜息肉样腺肌瘤进行临床病理资料分析、光镜观察及免疫组化染色。结果本组8例患者的发病年龄为38～53岁,中位年龄43.5岁。主要临床表现为阴道不规则出血。B超及宫腔镜示疑为子宫黏膜下平滑肌瘤和子宫内膜息肉。组织学主要表现为,增生性子宫内膜样腺体不规则散布于富含平滑肌的纤维性间质中;其中1例腺体结构复杂,腺上皮细胞轻～中度非典型性,为非典型性息肉样腺肌瘤(APA);7例为息肉样腺肌瘤。免疫组化:间质细胞SMA和desmin弥漫(+)。结论子宫内膜息肉样腺肌瘤是一种上皮和间叶组织混合的良性肿瘤,非典型性息肉样腺肌瘤具有复发倾向及恶变潜能,在活检标本中需与子宫内膜癌侵及肌层相鉴别。
Objective To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of endometrial polypoid adenomyoma. Methods Eight cases of endometrial polypoid adenomyoma were analyzed with clinicopathological data, light microscopy and immunohistochemical staining. Results The onset age of 8 patients in this group was 38-53 years, with a median age of 43.5 years. The main clinical manifestations of irregular vaginal bleeding. B ultrasound and hysteroscopy suspected uterine submucous leiomyoma and endometrial polyps. Histology mainly manifested as proliferative endometrial-like glands scattered irregularly in the smooth muscle-rich fibrous stroma; one case of glandular complex structure, mild to moderate atypical glandular epithelial cells, atypical Polypoid adenomyoma (APA); 7 cases of polypoid adenomyosis. Immunohistochemistry: interstitial SMA and desmin diffuse (+). Conclusions Endometrial polypoid adenomyosis is a kind of benign tumor mixed with epithelial and mesenchymal tissue. Atypical polyp adenoidoma has the tendency of recurrence and malignant transformation. In biopsy specimens, it is necessary to cooperate with endometrial carcinoma invasion and muscle Phase identification.