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目的探讨子宫血管周上皮样细胞肿瘤(PEComa)的临床病理特点、诊断及鉴别诊断。方法对1例子宫PEComa患者资料进行分析并复习相关文献。结果本例子宫PEComa位于肌壁间,瘤细胞呈上皮样或梭形,围绕血管呈巢状排列,胞浆透明或嗜酸,免疫组化染色HMB45、SMA阳性,随访15个月无瘤生存。结论发生于子宫的PEComa是一种少见的间叶性肿瘤,术前检查容易误诊,病理组织学及免疫组化特征性抗体HMB45、SMA表达有助于确诊。此瘤多数为良性,亦有恶性子宫PEComa的报道,其生物学行为尚不确定,有待进一步积累病例进行分析,为临床病理医师提供诊断、随访依据。
Objective To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of uterine perivascular epithelial cell tumor (PEComa). Methods One case of uterine PEComa patient data analysis and review of relevant literature. Results In this case, PEComa was located in the muscular wall. The tumor cells were epithelioid or spindle-shaped. Neoplasms were arranged in nests around the blood vessels, cytoplasm transparent or eosinophilic. Immunohistochemical staining of HMB45 and SMA showed no tumor-like survival after 15 months of follow-up. Conclusions The PEComa occurred in the uterus is a rare mesenchymal tumor. Misdiagnosis is easy before operation. The histopathological and immunohistochemical HMB45 and SMA expressions are helpful for the diagnosis. The majority of this tumor is benign, there are reports of malignant uterine PEComa, its biological behavior is not yet clear, to be further accumulated cases for analysis, to provide clinicians with pathological diagnosis, follow-up basis.