卵巢子宫内膜样间质肉瘤临床病理分析(附2例报道)

Endometrioid stromal sarcoma of the ovary:report of two cases and review of the literature

目的:探讨卵巢子宫内膜样间质肉瘤的临床病理特征、诊断与鉴别诊断以及治疗和预后。方法:对2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:肿瘤组织由形似增殖期子宫内膜间质细胞的小细胞组成,卵圆形或梭形,胞浆稀少,其间满布厚壁小血管类似子宫内膜螺旋小动脉,肿瘤细胞呈漩涡状围绕小血管。免疫组化CD10(+),CD99(+),ER(+),PR(+),α-inhibin(-),SMA(-)。网状纤维染色:网状纤维密布于肿瘤细胞之间。结论:卵巢子宫内膜样间质肉瘤是一种非常罕见的恶性肿瘤,组织学形态需与卵巢性索-间质肿瘤和卵巢肉瘤等鉴别。

Objective： To study the clinical pathological characteristics ,differential diagnosis ,therapy and prognosis of endometrioid stromal sarcoma of the ovary. Methods ： Two cases of endometrioid stromal sarcoma of the ovary were examined with light microscopy and immunohistochemistry and literature was reviewed. Results ： The tumor was composed of small cells resembling the stromal cells of proliferative endometrium . The tumor cells were orbicular - ovate or fusiform, which had rare cytoplasm and among which were small vessels with thick wall resembling endometrial spiral arteriole which were surrounded by whirlpool -form tumor cells. Immunohistochemically, the tumor cells were positive for CD10, CD99, ER and PR, and negative for α -inhibin and SMA. The reticular fiber staining showed dense reticular fibers enveloping individual tumor cells. Conclusion ： Endometrioid stromal sarcoma of the ovary is a malignant tumor which is extremely scarce . Differential diagnostic considerations of the tumor should include sex cord - stromal tumors of the ovary and ovarian sarcoma and so on.