子宫腺瘤样瘤15例临床病理分析

目的 探讨子宫腺瘤样瘤的发生、临床病理特点、免疫组化表达特征及鉴别诊断。方法 对15例子宫腺瘤样瘤进行临床病理、组织化学及免疫组织化学观察。结果 15例子宫腺瘤样瘤占同期子宫切除标本的1．81％，肿瘤多位于子宫浆膜下及近浆膜的子宫肌壁间，内膜下少见；2例呈弥漫性生长，13例呈结节状，结节直径0．5～5cm不等，临床表现无特征性。镜下见肿瘤由大小不等、形态不一的腺样及腔隙样结构组成，伴有间质平滑肌增生，分为丛状型、腺管型、脉管型及囊肿型。8例腔隙内黏液样物阿尔辛蓝染色（＋），PAS染色（-）。免疫表型：AE1／AE3、vimentin和calretinin（＋），CEA、ER、PR和CD31（-）。结论 子宫腺瘤样瘤并非罕见，支持间皮起源，临床及病理检查均易误诊和漏诊。免疫组化检查可作为诊断及鉴别诊断的重要参考依据。其生物学行为为良性，预后良好。

Adenomatoid tumor of uterus: a clinicopathological analysis of 15 cases

Objective To study the histogensis, the clinicopathological characteristics, the immunohistochemical feature and the differential diagnosisof adenomatoid tumors in uterus. Methods Clinical pathological analysis, histochemical and immunohistochemical studies were performed in 15 cases of adenomatoid tuner in the uterus. Results 15 cases of adenomatoid tumors of uterus were diagnosed, accounting for 1.81% of all hysterectomy at the same period. Most of them were located in the sub-serosa and the muscle wall, closed to the serosa. A few was under enclometrium. 2 cases were of diffuse type, and 13 cases were of solitary type. The nodules ranged from 0.5 - 5 cm in size. The clinical characteristics were not appearant.Microscopically, the tumor consisted of various gland-like or cystic-like patterns. All of them showed smooth muscle cell hyperplasia. The tumor was derided into plexiform type, tubular type, vesselar type and cystic type. 8 cases showed Aician blue positive, but negative for PAS. Immunohistochemical staining showed that tumor cells were positive for AE1/AE3, vimentin and calretinin, but negative for CEA, ER, PR, and CD31. Conclusions Adenomatoid tumors are not very rare in the uterus. Our results support this tmnor is from mesothelium in origin. Clinically and pathologically it is often misdiagnosed.Immunohistochemical staining is helpful for diagnosis and differential diagnosis. The biological behavior of adenomatoid tumor is benign and with a good prognosis.