子宫内膜间质肿瘤8例病理学研究

ENDOMETRIAL STROMAL TUMORS OF THE UTERUS:EIGHT CASES PATHOLOGIC ANALYSIS

本文通过分析八例少见的子宫内膜间质肿瘤的病理学特征,综合Norris和Taylor及yoonessi等的意见,提出如下诊断标准:1.此类肿瘤应由类似内膜间质细胞的恶性成份的同原性组织组成,不应含任何痛或异源性分化的成份;2.间质异位症的瘤细胞呈小团浸润。内膜肉瘤的瘤细胞弥漫成片浸润,可伴出血及坏死;3.核分裂活跃及细胞异型度:间质异位症为10个以下核分裂/10HPF,细胞异型度较轻。内膜肉瘤为10个以上核分裂/10HPF,细胞异型度明显。讨论了组织学的鉴别诊断。

Pathologic features of 8 patients with rare endometrial stromal tumors of the uterus were analysed. Microscopic findings were reviewed and according to the cri-teria of Norris and Taylor and Yoonessi et al, we proposed that 1) The tumors ineach instance consisted of homologous tissue resembling the malignant counterpartof endometrial stromal cells. None of them contained any elements of carcinoma ofheterologous differentiation. 2) In stromatosis, the neoplastic cells were arrangedin cohesive sheets and extensived into the myometrium consisted entirely of solitarysmall well-circumscribed mass, and in stromal sarcoma, diffusive sheets of thetumor cells were extensived into the myometrium combined with hemarrhage andnecrosis. 3) Mitotic activity and cellular atypical, stromal sarcoma have veryhigh mitotic rates that usually exceed 10 mitoses per HPF, while in the cases ofstromatosis generally manifest sparse mitotic activity, having fewer than 10 mitosesper HPF and frequently considerably less. The cel f stromal sarcoma also have anaplastic cytologic features that usually exceed those encountered in stromatosis.The histologic differential diagnosis was discussed.