子宫绒毛叶状分割性平滑肌瘤3例临床病理分析

Clinicalpathological analysis of 3 cases of cotyledonoid dissecting leiomyoma of the uterus

目的:探讨子宫绒毛叶状分割性平滑肌瘤的临床病理特征、诊断与鉴别诊断要点。方法:对3例子宫绒毛叶状分割性平滑肌瘤进行临床病理分析、组织形态学及免疫组织化学染色观察,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果:大体形态具有特征性,由子宫壁内和壁外两部分组成,以结节状分割子宫肌壁形式扩展。组织学观察瘤细胞表现典型的平滑肌分化,伴厚壁与薄壁的大血管,血管呈丛状分布,周围基质水肿明显,肿瘤组织在肌壁中较局限地分割,扩展性生长。免疫组织化学染色显示瘤细胞Vimentin、SMA强阳性,CD10阴性。结论:子宫绒毛叶状分割性平滑肌瘤是一种较罕见的良性肿瘤,大体形态具有特征性,应注意与子宫内膜间质肉瘤及其他类型平滑肌瘤的鉴别。

Objective：To explore the clinicopathological characteristics and the diagnostic and differential diagnostic features of cotyledonoid dissecting leiomyoma of the uterus. Methods：The clinicopathological analysis, histomorphologial observation, and immunohistochemical staining were performed in 3 cases of cotyledonoid dissecting leiomyoma of the uterus. Results ： The gross appearance showed that nodules dissected the intrauterine and extrauterine portion. There were micronodules of smooth muscle fascicles which were separated by fibrous connective tissue with hydropic changes and rich vascularity in cluster. The tumor cells were strongly positive for vimentin and SMA and negative for CD 10. Conelusion：Cotyledonoid dissecting leiomyoma of the uterus is a rare benign tumor with a distinctive gross appearance,which should be distinguished with that of endometrial stromal sarcoma and other types of smooth muscle tumor.