12例低级别子宫内膜间质肉瘤临床病理及免疫组化分析.docVIP

12例低级别子宫内膜间质肉瘤临床病理及免疫组化分析 　　[摘要] 目的 探讨低级别子宫内膜间质肉瘤（LGESS）的临床病理学及免疫组化特点。 方法 回顾性分析12例LGESS的临床及病理资料，并辅以免疫组织化学分析。 结果 患者临床表现为子宫肿块和阴道出血，术前临床诊断为子宫肌瘤或子宫腺肌病，确诊主要依据术后病理诊断。12例LGESS中，伴性索分化1例，合并平滑肌混合性肿瘤1例，合并子宫腺肌瘤2例，合并多发性子宫肌瘤4例。组织形态均显示瘤细胞由浸润性、弥漫性增生的单一性圆形或梭形细胞组成。LGESS由类似增生期子宫内膜间质的肿瘤细胞构成，伴有丰富的螺旋小动脉，呈浸润性生长。免疫组化：瘤细胞的CD10和vimentin均（++++），ER（+），PR（+++），CK5/6（-~+），EMA（-~+），S-100和CD34均为（-），CD34在肿瘤组织的血管内皮细胞为（+）。 结论 临床术前明确诊断LGESS有困难，但结合临床病理特征及免疫组化标记，可以做出正确诊断。 　　[关键词] 低级别子宫内膜间质肉瘤；子宫肿瘤；免疫组化 　　[中图分类号] R737.33 [文献标识码] B [文章编号] 1673-9701（2012）04-0114-03 　　 　　Clinicopathological features and immunohistochemical studies of 12 cases low-grade endometrial stromal sarcoma 　　ZHU Meijuan 　　Department of Pathology, Jiading Distric Maternal and Child Health Hospital, Shanghai 201800, China 　　[Abstract] Objective To explore the clinicopathological features and immunohistochemical characteristics of low-grade endometrial stromal sarcoma. Methods The clinical and pathological data of 12 cases were retrospectively analyzed, and combined with immunohistochemistry. Results Patients with clinical manifestations of the uterus tumor and vaginal bleeding were misdiagnosed as uterine leinmyoma or ademomyosis before surgery. Diagnosis was mainly confirmed by pathologic results after surgery. Among the 12 cases, there was 1 case with sex-cord differentiation and 1 case with mixed smooth muscle tumor. There were 2 cases with uterine adenomyoma and 4 cases with multiple uterine leinmyoma. Histologically, tumor cells consisted of infiltrative and diffuse round or ovary cell. LGESS was typically composed of similar with proliferative endometrial mesenchymal cells with obvious small helix arteries and presented invasion reaching the uterine muscular layer. Immunohistochemistry showed the tumor cells were CD10 (++++), vimentin (++++), ER (+), PR (+++), CK5/6 (-~+）, EMA (-~+), S-100 and CD34 (-). The vascular endothelial cells were positive for CD34 in tumor tissue. Conclusion It is difficult to confirm LGESS befor