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目的探讨伴有支持细胞样结构的子宫内膜样癌的临床病理特点、免疫组化及诊断与鉴别诊断。方法观察1例伴支持细胞样结构的子宫内膜样癌的组织学形态及免疫组化特点,并复习相关文献,综合分析其临床病理特征。结果伴有支持细胞样结构的子宫内膜样癌由支持细胞瘤样结构和经典型子宫内膜样癌组成,部分肿瘤细胞成巢状或索状排列,其间可见中空的小管状结构,类似卵巢支持细胞肿瘤的组织学形态。免疫组化显示肿瘤细胞CK、ER和PR(+),CD99灶状(+),Ki-67阳性细胞数<5%,而a-Inhibin、Cg A、Syn和CD56均呈(-)。结论伴有支持细胞样结构的子宫内膜样癌是罕见的子宫内膜样腺癌的组织学亚型,与卵巢的支持细胞瘤易混淆,应充分取材,仔细寻找镜下经典的子宫内膜样腺癌的结构,并结合免疫组化与子宫性索样肿瘤等进行鉴别。
Objective To investigate the clinicopathological features, immunohistochemistry, diagnosis and differential diagnosis of endometrioid carcinoma with supporting cell-like structures. Methods One case of endometrial carcinoma with supporting cell-like structure was observed histologically and immunohistochemically. The related literatures were reviewed and their clinicopathological features were analyzed comprehensively. Results The endometrioid carcinoma with supporting cell-like structure consisted of supporting cell tumor-like structure and classic endometrioid carcinoma. Some of the tumor cells were nested or cord-shaped with a small hollow tubular structure resembling ovary Support the histology of cell tumors. Immunohistochemistry showed that CK, ER and PR (+), CD99 (+), Ki-67 positive cells were less than 5%, while a-Inhibin, Cg A, Syn and CD56 were all negative. Conclusions Endometrioid carcinoma with supporting cell-like structure is a rare histological subtype of endometrioid adenocarcinoma that is confused with ovarian hematopoietic tumor. It should be fully drawn and carefully searched for the classic endometrial speculum Like adenocarcinoma of the structure, combined with immunohistochemistry and uterine cord-like tumors were identified.