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目的探讨子宫恶性中胚叶混合瘤的临床病理形态、诊断及鉴别诊断。方法回顾性分析5例子宫恶性中胚叶混合瘤的临床资料、组织学特征及免疫组化特点。结果 5例患者均为绝经后,年龄59~68岁,中位年龄63.5岁,绝经10~14年。临床表现为异常阴道出血、排液,伴下腹或盆腔疼痛。镜下肿瘤由恶性上皮及恶性间叶组织构成。免疫组化结果显示,5例上皮性肿瘤成分均表达CK,3例上皮同时表达ER、PR,5例间叶性肿瘤成分均表达Vimintin和Actin,3例同时表达CD10,4例横纹肌肉瘤成分表达Desmin,2例软骨肉瘤成分表达S-100。结论子宫恶性中胚叶混合瘤是好发于老年妇女的少见高度恶性肿瘤,临床表现无特异性,充分取材,将镜下形态与免疫组化相结合可帮助诊断。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of mixed malignant mesoderm in uterus. Methods The clinical data, histological features and immunohistochemical characteristics of 5 malignant mesothelioma mixed tumors were retrospectively analyzed. Results All the 5 patients were postmenopausal, aged 59-68 years, with a median age of 63.5 years and menopause of 10-14 years. Clinical manifestations of abnormal vaginal bleeding, drainage, with abdominal or pelvic pain. Microscopic tumor consists of malignant mesenchyme and malignant mesenchyme. The results of immunohistochemistry showed that CK was expressed in all 5 epithelial tumors, ER and PR were expressed in 3 epithelium, Vimintin and Actin in 5 mesenchymal tumors, 3 in CD10 and 4 in rhabdomyosarcoma Desmin, 2 cases of chondrosarcoma component expressed S-100. Conclusion Malignant mesodermal mixed tumor of the uterus is a rare high grade malignant tumor in elderly women. The clinical manifestations are nonspecific and fully drawn. The combination of microscopic morphology and immunohistochemistry can help diagnose.