卵巢子宫内膜样间质肉瘤临床病理观察

目的探讨卵巢子宫内膜样间质肉瘤的发生机制、临床病理特征、诊断与鉴别诊断及预后。方法 对1例卵巢子宫内膜样间质肉瘤进行光镜、免疫组化检测, 并复习有关文献。结果 肿瘤组织由形似增生期子宫内膜间质细胞的小细胞组成, 瘤细胞呈卵圆形或短梭形, 胞浆稀少, 肿瘤细胞呈漩涡状围绕似子宫内膜螺旋小动脉的厚壁小血管。免疫组化示瘤细胞表达Vimentin和CD10, 不表达Calretinin, α-inhibin, H-caldesmon, CD99, CD117, CD34, desmin, SMA and CK(AE1/AE3)。结论 卵巢子宫内膜样间质肉瘤在临床为一惰性生长的恶性肿瘤, 非常罕见。其鉴别诊断主要包括子宫内膜间质肉瘤累及卵巢(直接侵犯或转移)和卵泡膜细胞-纤维瘤。     

卵巢子宫内膜样间质肉瘤1例报道及文献复习

目的：报道1例卵巢子宫内膜样间质肉瘤并进行文献复习。方法：对1例卵巢子宫内膜样间质肉瘤进行组织病理学、免疫组化检测,并复习文献。结果：光镜下肿瘤组织由类似于子宫内膜样间质细胞的小细胞构成。肿瘤细胞核呈卵圆形或短梭形,胞浆稀少,围绕着厚壁小血管生长。这种小血管与分泌晚期子宫内膜的螺旋小动脉相似,弥散分布于肿瘤细胞之间。免疫组化显示肿瘤细胞CD10、vimentin、ER、PR阳性,desmin灶性阳性,Ki-67〈20％,α-inhibin、SMA、S-100阴性。结论：卵巢子宫内膜样间质肉瘤是一种罕见的恶性肿瘤,组织学形态需与卵巢性索间质肿瘤、卵巢其他肉瘤等鉴别。     

子宫内膜间质肉瘤9例病理分析

我院自 1984年 8月至 2 0 0 2年 3月收治 9例子宫内膜间质肉瘤 (endometrialstromalsarcoma ,ESS)患者 ,现报告如下。1　材料与方法1.1　材料参照WHO的诊断标准[1] ,根据是否浸润周围组织分为良性子宫内膜间质结节和间质肉瘤。又根据镜下肿瘤细胞的异型性 ,核分裂相多少及与血管、淋巴管的关系 ,将 9例间质肉瘤分为低度恶性型 (5例 )和高度恶性型 (4例 )。1.2　方法标本常规处理 ,石蜡切片。选择瘤细胞最丰富处计数 5 0个高倍视野核分裂相 ,以平均值计算每 10个高倍视野的核分裂相数 ,并以此划分其恶性程度。采用S P法检测ER、PR、Vim…     

子宫内膜间质肉瘤六例临床病理分析

目的 对６例子宫内膜间质肉瘤进行临床病理分析，以探讨其诊断、鉴别诊断和治疗的方法。方法 对我院１９８９～１９９９年收治６例子宫内膜间质肉瘤进行回顾性分析，并随访其手术化疗治疗效果。病理资料重行常规切片、光镜观察，免疫组化染色。结果 ６例子宫内膜间质肉瘤全部行手术治疗，术后辅以化疗等综合治疗，随访转移死亡２例，采用Ｓ－Ｐ法行免疫组化染色，６例肿瘤细胞均表达Ｖｉｅｍｎｔｉｎ（＋），Ｄｅｓｍｉｎ（＋）。结论 子宫内膜间质肉瘤较少见，好发于绝经前后妇女，不规则出血，迅速增大的腹块为主症，术前主要依靠Ｂ超检查诊断。病理组织学、免疫组化染色对子宫内膜间质肉瘤确诊、分型、鉴别诊断均有重要意义，手术切除辅以术后化疗仍是主要治疗方法，     

子宫内膜间质肉瘤9例临床分析

子宫内膜间质肉瘤属于子宫肉瘤的一种类型。它原发于子宫内膜间质细胞。迄今，其病因尚未明确，而治疗仍以手术为主，配合放疗、化疗。我所1994年6月—1998年6月共收治9例子宫内膜间质肉瘤患者，现将临床资料分析如下。……     

子宫内膜间质肉瘤23例临床分析

目的 探讨子宫内膜间质肉瘤的诊断、治疗及预后。方法 回顾性分析23例子宫内膜间质肉瘤的临床资料。全部病例均经手术治疗。基本术式为全子宫双侧附件切除，术后辅以化疗和放疗。结果 确诊主要依靠病理结果，23例中高度恶性5例，低度恶性18例。结论 子宫内膜间质肉瘤的恶性度与预后关系密切，应术前或术中确诊，作广泛的切除，术后辅助放疗和化疗，以减少复发和提高存活率。     

低度恶性子宫内膜间质肉瘤30例临床病理分析

采用HE染色及免疫组化技术对30例低度恶性子宫内膜间质肉瘤进行观察。发现以中年妇女多见,主要症状为阴道不规则出血,CD10阳性,desmin灶状阳性。     

子宫内膜间质肉瘤五例临床病理分析（附一例电镜观察）

子宫内膜间质肉瘤五例临床病理分析（附一例电镜观察）广州市第六人民医院病理科（５１０６５５）程嘉骧中山医科大学病理解剖学教研室林汉良子宫内膜间质肉瘤虽少见，但临床表现和镜下形态易与子宫其它疾病混淆而造成漏诊和误诊。现将作者收集的５例报告如下。材料与方法...     

50例子宫内膜间质肿瘤临床病理分析

目的:探讨子宫内膜间质肿瘤的临床、病理及其多成分分化特点、鉴别诊断及预后。方法:分析50例子宫内膜间质肿瘤(子宫内膜间质结节6例、低度恶性子宫内膜间质肉瘤30例、未分化子宫内膜肉瘤11例、子宫内膜间质平滑肌混合瘤3例)的临床、病理、合并症、鉴别诊断及预后。结果:不同类型肿瘤均有部分病例伴多成分分化,(12例伴平滑肌分化、10例伴性索样分化、1例伴纤维分化、1例伴纤维粘液样分化、1例伴上皮样分化,其中10例同时伴两种分化成分)。50例中有9例伴发子宫平滑肌瘤(其中1例同时伴发腺瘤样瘤,1例伴发高分化子宫内膜腺癌)。结论:不同类型子宫内膜间质肿瘤均可伴发多成分分化及其他类型肿瘤,具备多样性病理形态特征,肿瘤有无浸润及肿瘤细胞异型程度、核分裂象数量是确定本瘤性质的必备条件。     

子宫内膜间质肉瘤19例临床病理分析

目的探讨子宫内膜间质肉瘤(ESS)的临床病理特征及激素受体表达情况.方法对19例病例进行总结分析并做免疫组化染色.结果ESS多见于30～50岁青壮年;判断ESS的恶性度主要依据肿瘤累及范围及瘤细胞异型性,核分裂计数起参考作用;免疫组化证实瘤细胞具有多潜能性分化且雌、孕激素受体表达率较高.结论ESS的恶性度要严格按照标准区分,ESS内分泌治疗效果较好,前景令人鼓舞.     

Post-hysterectomy extra-uterine endometrial stromal sarcoma: a case report

Endometrial stromal sarcoma is a relatively rare form of uterine sarcoma. The present paper reports on a patient who was found to have contracted endometrial stromal sarcoma eight years after a hysterectomy. A postoperative specimen revealed this sarcoma to have originated in extra-uterine endometrium of the rectovaginal septum.     

Positron emission tomography imaging of oestrogen receptor-expression in endometrial stromal sarcoma supports oestrogen receptor-targeted therapy: Case report and review of the literature

Although the majority of endometrial stromal sarcomas (ESSs) express oestrogen receptor (ER), data on the efficacy of ER-targeted therapies are scarce. Using PubMed search engine we identified nine case reports and small series in a total of 25 patients reporting on the efficacy of palliative ER-targeted therapies. Literature supports the efficacy of aromatase inhibitors after the failure of progestins, but not of the partial ER-antagonist tamoxifen. Fulvestrant is a pure ER-antagonist with a distinct mechanism, of which efficacy has not yet been reported in ESS. We present a patient that underwent positron emission tomography and computed tomography (PET/CT) of ER-expression with the tracer ¹⁸F-fluoroestradiol (FES). High levels of ER-expression provided a rationale for fulvestrant therapy. FES-PET/CT was repeated after 6 months and indicated a strong decrease in tumour FES-uptake, and 15% reduction in tumour diameters according to Response Evaluation Criteria in Solid Tumours (RECIST) criteria.     

Analysis of 6 cases of stromal sarcoma of the breast

OBJECTIVE To investigate the clinical and pathological characteristics, diagnosis and treatment of stromal sarcoma of the breast （SSB）. Methods： The clinical and pathological data of 6 patients with SSB treated between 1954 and 2007 were retrospectively analyzed.
METHODS The clinical and pathological data of 6 patients with SSB treated between 1954 and 2007 were retrospectively analyzed.
RESULTS All patients were female and one was menopausal. The median age of the patients was 39 years old （range, 20-55）. All cases had a history of a palpable mass. The tumor rapidly augmented in a short time period in 3 patients. One patient had discontinuous pain and 3 patients had masses located in the upper outer quadrant of the breast. The median tumor radius was 6.0 cm （range, 3-15 cm）. According to the AJCC breast cancer staging standard （6th edition）, 1 case was of stage ⅡA, 2 cases were of stage ⅡB, 2 cases were of stage ⅢB and one case couldn＇t be staged. Four patients were initially treated by excising the tumor and then undergoing mastectomy or modified radical mastectomy after recurrence. Radical mastectomy was suitable for those with pectoralis major muscle involvement. Two patients received simple mastectom）~ 2 patients underwent radical mastectomy and another 2 patients received modified radical mastectomy. After surgery, all patients were identified as SSB through pathology, with focal ossification in one case and mucinous degeneration in another one case. Four patients who underwent axillary lymph node dissection did not have lymph node metastases. Three patients received chemotherapy after surgery. After a median follow-up time of 36.5 months （8-204 months）, 4 patients had recurrence after local excision and 3 patients had recurrence more than 2 times with a median time to recurrence of 2.5 months （1 to 4 months） after surgery. One patient had lung metastases at 7 months after the initial surgery and the other 5 patients were alive without disease at the end of the follow-up period.
CONCLUSION SSB is difficult to diagnose preoperatively and is characterized by its tendency to .recur locally. To obtain negative margins, wide local excision or mastectomy must be performed. Axillary lymph node dissection is not mandatory. The roles of adjuvant chemotherapy and radiotherapy have still been controversial.     

Endometrioid ovarian carcinoma benefits from aromatase inhibitors: case report and literature review

Aromatase inhibitors have not been adequately assessed in treatment of ovarian cancer. The aromatase inhibitor letrozole (2.5 mg daily) was administered in 2 cases of advanced endometrioid ovarian cancer with positive estrogen receptor. CASE 1: A 52-year-old woman with a grade 2-3, stage iiic endometrioid ovarian cancer was optimally debulked and received 6 cycles of intravenous paclitaxel and intraperitoneal cisplatin-paclitaxel. Post chemotherapy, one of several biopsies showed residual disease during the second-look laparoscopy. This patient was treated with letrozole and remained disease-free during 30 months of follow-up. CASE 2: A 47-year-old woman with a grade 3, stage iiic endometrioid ovarian cancer was optimally debulked and treated with intravenous carboplatin-paclitaxel. After a 15-month remission, her first recurrent disease was treated with carboplatin-docetaxel. The second remission lasted only 11 months, after which the patient was treated with splenectomy and subsequent liposomal doxorubicin. Letrozole was administered after the chemotherapy. The patient had a 30-month remission before the next recurrence of her disease. CONCLUSIONS: Endometrioid ovarian carcinoma may benefit from aromatase inhibitors, especially when the tumour burden is low after primary chemotherapy or when the inhibitor is used as maintenance therapy between chemotherapies.     

Acute myeloid leukaemia presenting with mediastinal myeloid sarcoma: report of three cases and review of literature

Although myeloid sarcomas (MS) are frequently associated with acute myeloid leukaemia (AML), the occurrence of mediastinal MS is a much rarer event. The authors describe a distinct group of three AML patients with mediastinal MS and complex cytogenetics presenting at their centre over a 7-year period. Clinical features consistent with superior vena caval obstruction were noted at presentation in two of the three patients. Mediastinal mass was detected on routine chest radiography, and biopsies confirmed the diagnosis of MS. One patient relapsed after consolidation chemotherapy and died from progressive disease. Two patients underwent allogeneic haemopoietic stem cell transplant, but succumbed to transplant related complications. Review of mediastinal MS over the last 20 years shows that a significant proportion of patients have complex cytogenetic abnormalities and a poor long-term prognosis. Early and accurate diagnosis is essential and patients should be managed along the lines of high risk AML.     

肾原发性肉瘤附8例报告并文献复习

目的:探讨原发于肾脏肉瘤的临床组织发生、病理学特点、诊断、治疗及预后。方法:总结我院收治8例原发性肾肉瘤患者临床资料,对肾肉瘤标本进行常规HE、免疫组织化学染色观察。复习相关文献。结果:8例显微镜下表现、组织化学及免疫组织化学染色分别显示平滑肌肉瘤、脂肪肉瘤、粘液肉瘤、肾滑膜肉瘤、恶性纤维组织细胞瘤的特点。由病理确诊,术前仅1例怀疑肉瘤。结论:肾原发性肉瘤少见,临床诊断较困难,主要表现为患侧腰疼,肿块。依靠病理检查,配以免疫组织化学染色可确诊。手术切除病肾是唯一可行方法。预后甚差,化疗、放疗效果争议较大。     

Synchronous granular cell tumor of the bladder, endometrial carcinoma and endometrial stromal sarcoma

We describe a very rare case of synchronous granular cell tumor of the bladder, endometrial carcinoma and endometrial stromal sarcoma. A 55‐year‐old woman with a 4‐month history of genital bleeding was cytologically diagnosed with endometrial carcinoma. Imaging studies suggested concomitant bladder tumor with the possibility of direct invasion from endometrial carcinoma. Total abdominal hysterectomy with bilateral salpingo‐oophorectomy and transurethral resection of bladder tumor was performed. The bladder tumor comprised polygonal cells with abundant eosinophilic, finely granular cytoplasm, separated by collagenous tissue. Neither nuclear pleomorphism nor tumor necrosis was found. Immunohistochemical expression of neural markers of neuron‐specific enolase and S‐100 allowed the diagnosis of granular cell tumor (GCT) of the bladder. Microscopic examination of endometrium revealed endometrioid adenocarcinoma with squamous differentiation (EAC). Ill‐defined nodular lesion comprising endometrial stromal sarcoma (ESS) was accidentally found in myometrium. Postoperatively, the patient underwent radiotherapy. This is the first well‐documented case of synchronous triple tumors comprising GCT of the bladder, uterine EAC and ESS.     

Mesenchymoma: A review of literature and report of two cases

Both benign and malignant varieties of the mesenchymoma have been described. Previously reported cases of mesenchymoma in the head and neck are rare. Two cases of mesenchymoma occurring intraorally are reported here. In each case local excision has effected apparent cure, for periods of 12 yr and 8 mo, respectively. Local excision is advocated as the primary treatment for such lesions occurring in the oral cavity. Although recurrences in areas other than the oral cavity tend to undergo malignant changes, this phenomenon has not been demonstrated in lesions occurring in oral tissues.