子宫性索样肿瘤临床病理分析

目的：探讨罕见子宫性索样肿瘤的病理特征、诊断及鉴别诊断。方法对2例子宫性索样肿瘤的临床资料、病理形态学和免疫组化染色进行观察。采用免疫组织化学En Vision法检测肿瘤细胞中Calratinin、CD99、CAM5．2、Vimetin、P16、P53、α-inhibin、Ckpan、Melan、ER、PR、CD10、Ki-67的表达情况，并复习相关文献。结果两例均为绝经后女性，临床主要症状是阴道不规则出血。镜下见肿瘤细胞较小，呈圆形或卵圆形，大小一致，可见核仁，无核沟，核分裂像少见，胞质丰富，嗜伊红，呈上皮样分化，类似卵巢颗粒细胞或支持细胞，肿瘤细胞排列方式多样化，呈相互吻合的小梁状结构，排列整齐的小管、腺样结构，甚至乳头状、血管瘤样结构，少见实性细胞团，呈推挤式浸润性生长，缺失call-exner小体结构。结论子宫性索样肿瘤是非常少见的肿瘤，具有恶性潜能或复发的可能，病理诊断时应与伴有性索样结构的子宫平滑肌肿瘤、低分化腺癌、上皮样平滑肌瘤等肿瘤鉴别。

Clinicopathologic features of uterina tumor resembling ovarian sex corol tumor

Objective To study the clinicopathological features, diagnosis and differential diagnosis of uterina tumor resembling ovarian sex corol tumor （ UTROSCT ） . Methods Two cases of UTROSCT were studied with clinical data, clinicopathogical observation and immunohistochemistry staining.The expressions of Calratinin, CD99, CAM5.2, Vimetin, P16, P53, α-inhibin, CKpan, Melan, ER, PR, CD10 and Ki-67 in tumor cells were detected with En Vision methods.Related literatures were reviewed as well.Results Two cases were postmenopausal women, and the main clinical manifestation was irregular vaginal bleeding.Tumor cells were small, round or ovoid with same size.Nucleoli could be found without nuclear groove.Mitotic activity was rare with abundant kytoplasm.They looked like granulose cell or sertoli cell.Cords, nests, trabecular ribbons and hemangioma pattern could be seen, and the growth pattern were justle and invasion.Call-exner cytorycte was not found.Conclusion UTROSCT is rare with malignant potential or recurring possibility.It should be differentially diagnosed from uterine leiomyoma, poorly differentiated adenocarcinoma, and epithelioid leiomyoma.