26例子宫内膜间质肉瘤临床病理分析

目的探讨子宫内膜间质肉瘤的发生、临床病理特点及鉴别诊断。方法对26例子宫内膜间质肉瘤进行临床病理及免疫组织化学观察。结果 26例子宫内膜间质肉瘤患者平均年龄47岁,临床表现为阴道异常出血,妇科检查5例可见宫颈口或阴道内的赘生物,15例行宫腔诊刮送检病理确诊。镜下主要由类似增殖期子宫内膜间质的肿瘤细胞组成,其间螺旋小动脉多见。免疫组化CD10、ER、PR常表达阳性,SMA、h-caldesmon、Desmon表达阴性。结论子宫内膜间质肉瘤是子宫肉瘤最常见的组织学类型,但临床发病率低且容易误诊,免疫组化可作为诊断和鉴别诊断的参考依据,全子宫和双侧附件切除是其标准的手术方式,预后差异较大。

Clinical pathological analysis of 26 cases with endometrial stromal tumors

Objective To study the histogensis the clinicopathological characteristics and the differential diagnosis of endometrial stromal tumors. Methods Clinical pathological analysis and immunohisto- chemical studies were performed on 26 cases of endometrial stromal tumors.Results 26 cases of uterine sarcoma average age matter in patients 45 years of age, clinical manifestations of abnormal vaginal bleeding, gynecological examination visible in 5 cases of cervical or vaginal neoplasm, 15 cases with intrauterine curettage for pathological diagnosis. Under the microscope by similar proliferative endometrium stromal tumor cells, the spiral arterioles. Immunohistochemical staining offen showed positive for CD10、ER、PR, and showed negative for SMA、h-caldesmon、Desmon. Conclusion Endometrial stromal sarcoma is the most common type of uterine sarcoma tissue, but the clinical incidence was low and easy to be misdiagnosed, immunohistochemistry can be used as the reference for the diagnosis and differential diagnosis.The uterus and bilateral accessory resection is the standard mode of operation, the prognosis is difference.