子宫静脉内平滑肌瘤临床病理分析

目的 探讨子宫静脉内平滑肌瘤的临床生物学特征及治疗手段对预后的影响。方法 对北京协和医院和江西省妇幼保健院1992年6月至2003年6月间收治并经手术及病理检查证实的子宫静脉内平滑肌瘤7例患者的临床和病理资料进行回顾性分析,全部病例均随访。结果 临床表现：7例患者均以盆腔包块为主诉,其中3例盆腔包块超过妊娠12周子宫大小,最大者妊娠16周大小;2例表现为经期延长、经量增多,1例表现为绝经后出血。超声检查：4例提示子宫肌瘤,1例提示子宫肉瘤,2例提示卵巢肿瘤,术前确诊率为0。术中冰冻检查：2例中1例确诊。手术治疗：4例行全子宫及双侧附件切除术,2例行全子宫及一侧附件切除术,1例仅行肌瘤剔除术;1例行子宫及一侧附件切除术患者术后2年复发,瘤栓沿下腔静脉转移至右心房及右心室再次手术治疗。结论 子宫静脉内平滑肌瘤具有特殊的不良生物学行为,提高术中确诊率与正确选择手术方式及术后密切随诊可以改善其预后。     

子宫非典型性平滑肌瘤合并大量腹水一例

子宫非典型性平滑肌瘤合并大量腹水一例李宝珠朱力范逢晓患者４３岁。因腹胀２个月，近１个月加重，伴食欲减退及体重下降，于１９９５年７月１５日入院。妇科检查：宫颈光滑，子宫大小正常，宫体右后方可触及１２ｃｍ×１０ｃｍ×１０ｃｍ肿物，囊实性感，边界清楚，活动...     

卵巢原发性平滑肌瘤及平滑肌肉瘤的临床与病理分析

本文报道卵巢原发性平滑肌来源的肿瘤５例，其中４例为平滑肌瘤，１例为平滑肌肉瘤。本文对卵巢平滑肌及平滑肌肉瘤的临床表现、病理学特征、诊断标准、组织学来源、鉴别诊断、治疗及预后作了论述。建议临床及理医生在实践中给予重视以免漏诊和误诊。     

多发子宫平滑肌瘤合并肠道平滑肌瘤1例

患者54岁,住院号176620。因发现盆腔包块3个月,于2003年3月14日入院。平素月经规律,末次月经2003年3月3日,量少淋漓不尽11天。3个月前无意中发现下腹包块,约手拳大小,因无症状故未治疗。半月前体检,B超提示子宫多发肌瘤,子宫内膜增厚。查体:P80/min,BP14.7/9.0kPa。下腹正中可触及一手拳大小包块,质硬,活     

子宫富细胞平滑肌瘤47例临床病理分析

研究了了宫富细胞平滑肌瘤的临床及病理特征。方法分析了４７例子宫富细胞平滑肌瘤的临床及病理特征,并对其中３５例进行追踪随访。结果本病症状主要包括月经改变、贫血、疼痛、不孕主前诊断均为子宫肌瘤。结论子宫富细胞平滑肌瘤是一种良性肿瘤,术后不必补充化疗或放疗,预后良好。     

子宫平滑肌瘤红色变性7例分析

<正> 子宫肌瘤是女性生殖器官中最常见的良性肿瘤,但发生红色变性者较少见,我院1992年至1995年诊治子宫平滑肌瘤红色变性7例,现报告如下。 1 临床资料 1992年至1995年我院诊治子宫平滑肌瘤     

子宫上皮样平滑肌瘤伴囊性变2例

例1.27岁,孕0产0,住院号153503。因婚后2年未孕就诊,以“子宫肌瘤”为诊断于2000年12月11日入院。1998年9月婚检B超发现子宫内占位病变。月经规则,经量正常。末次月经2000年11月19日。妇科检查:子宫颈中度糜烂,子宫前位,孕3个多月大小,形态不规则,质地中等,活动可,无压痛。B超提示:子宫右侧壁混合回声占位(子宫肌瘤?)。于12月13日行肌瘤挖出术。病理报告(病理号2000—2967):子宫上皮样平滑肌瘤伴部分囊性变。     

子宫平滑肌瘤并腺瘤样瘤1例

一、病例摘要患者,40岁,汉族,因月经期小腹疼痛4年、阴道不规则流血3个月于2004年10月25日入院。妇科检查:阴道血染,子宫颈光滑,子宫大小如孕3个月。B超示:子宫占位性病变。手术所见:子宫增大如孕3个月,浆膜面光滑。大体标本检查:次全切子宫标本一个,大小为7cm×6.5cm×5.5cm,表面光滑,纵行剖开子宫,子宫前壁厚1.5cm,后壁厚2cm,子宫内膜厚0.2cm,在子宫后壁肌壁间可见两个结节状肿物,大小分别为:2.5cm×2.5cm×2.3cm、1cm×0.8cm×0.6cm,切面灰白色、漩涡状、质韧、有明显假包膜。在子宫底肌壁间可见2.5cm×2cm×2cm的局限性结节,结节与周围…     

Borderline smooth muscle tumors of the uterus

At present, decision regarding where to place a uterine smooth muscle tumor that deviates from the most obvious leiomyoma and leiomyosarcoma groups still depends on time-honored conventional criteria. The focus of categorization should be the clinical outcome and not nosology. To improve accuracy in predicting clinical behavior, a multivariate approach is needed. This involves combining background clinical information, intraoperative and gross findings,multiple relevant morphologic criteria, and immunohistochemical studies. The authors believe that in future, as the number of cases with intermediate clinical outcome and morphologic features increases, and as molecular markers of prognosis are studied, managing these tumors will become more objective.     

Clinical update of smooth muscle tumors of the uterus

Smooth muscle tumors of the uterus represent a spectrum of diseases that range from benign leiomyoma to malignant leiomyosarcoma. The leiomyoma is the most common of these neoplasms. Clinically, it is important to fully understand the differences in clinical presentation, biologic behavior, and management for patients with benign leiomyoma, smooth muscle tumors of uncertain malignant potential, and leiomyosarcoma. The goal of this review is to present the most recent information about common smooth muscle tumors of the uterus including their etiology, histopathology, radiographic and clinical presentations, and available treatment options.     

Morphologic features of prognostic significance in uterine smooth muscle tumors: a review of eighty-four cases.

Independent microscopic review of the most cellular and pleomorphic areas of 84 smooth muscle tumors of the uterus by two pathologists yielded 23 leiomyosarcomas, 43 cellular leiomyomas, 16 bizarre leiomyomas, and two intravenous leiomyomas. Greater than 5 mitotic figures/10 high-power fields (hpf) correlated with malignant clinical behavior, but this occurred in only 75% of the leiomyosarcomas. Five cases with fewer than 5 mitoses/10 hpf pursued a malignant course. The mean age of the patients with malignant tumors (52.5 years) was similar to the mean age of those with bizarre leiomyomas (48.0 years) but those patients with cellular leiomyomas were significantly younger (42.0 years; p less than 0.01). Gross evidence of extrauterine extension was diagnostic of malignancy as was vascular invasion by anaplastic tumor. Fifteen of the 19 patients with leiomyosarcoma died of disease at an average of 28 months postoperatively. Inadequate sampling and interobserver variation are discussed.     

Three-dimensional structure of the smooth muscle in the term-pregnant human uterus

Objective: To identify the structural elements and describe the three-dimensional microanatomy of the term-pregnant human uterus.Methods: Biopsy specimens were taken from the funduses and the lower uterine segments of two term-pregnant uteri. Tissue was sectioned serially and stained with Masson trichrome. Microscope images were captured with a digital camera, aligned, and computer-processed. Computer-assisted three-dimensional reconstruction of structures was performed.Results: Five structures were identified: 1) fasciculus—the macroscopic organization of myocytes and connective tissue, 2) cylindric bundle—300 ± 100-μm diameter cylinder of densely packed myocytes, 3) sheet-like bundle—densely packed sheet of myocytes, 4) fiber bundle—a loosely packed bundle of small numbers of myocytes, and 5) communicating bridge—a large cylindric bundle that bridges adjacent fasciculi. The cylindric bundles merged, dichotomized, and intertwined with each other and with sheet-like bundles. Essentially all myocytes except those in fiber bundles were contiguous.Conclusion: The microanatomy of the term-pregnant human uterus contains clearly defined structural elements. These structures merge with each other and potentially form an interlacing network, connecting the vast majority of the myocytes of the uterus in a contiguous pathway.     

Histologic and chemical studies of the smooth muscle in the human cervix and uterus

This study compared chemical and histological measurements of the amount of smooth muscle in the human cervix to determine the extent of correlation of the 2 types of quantifications. Macroscopically normal uteri and cervical specimens from 31 nonpregnant women, aged 21-55 years, were studied. Histological estimates were made of muscle amount, and chemical measurements of actomyosin were made. It was seen that the mean muscle content of the cervix increased from the lower to the upward part. The smallest amount (6.4%) was in the lower cervix; midcervix muscle content increased to 18%; and upper was 28.8%. Chemically, the mean actomyosin content of the uterus was significantly greater than that of the cervix (7.54 vs. 3.72 mg/gm) (P=.01). The 2 types of measurements were correlated in their ability to quantitate muscle mass and amount in the human cervix.     

Giant adenomatoid tumors of the uterus.

Two cases of adenomatoid tumor of the uterus of unusually large size are reported. One was 12 cm, the other 13 cm in diameter and one was located in the lateral wall and the other in the posterior wall of the uterus. Both were an unusually large or giant variant of adenomatoid tumor of the uterus. The cystic macroscopical and microscopical pattern is characteristic of giant adenomatoid tumors. The origin of these neoplasms is discussed.