7例子宫奇异型平滑肌瘤临床病理分析

Clinicopathologic analysis of seven cases of uterine bizarre leiomyoma

目的探讨子宫奇异型平滑肌瘤的临床病理特点、诊断及鉴别诊断,提高对子宫奇异型平滑肌瘤的认识。方法回顾性分析7例子宫奇异型平滑肌瘤的临床资料及病理特征。结果患者的主要临床表现为子宫增大、阴道不规则流血、腹痛、盆腔包块等。镜下部分或全部细胞核奇异,可见巨核、多核及核内粉红染云雾状假性包含体,核分裂象1～2个/10高倍视野(HPF)。结论子宫奇异型平滑肌瘤临床上比较少见,易误诊,其病理诊断及鉴别诊断主要依靠苏木精-伊红(HE)切片观察。子宫奇异型平滑肌瘤细胞形态虽奇异,但属良性肿瘤,手术切除为最佳治疗方法。

Objective To investigate the elinieopathologie characteristics,diagnosis and differential diagnosis of bizarre leiomyoma of uterus,sublime the understanding of bizarre leiomyoma of uterus. Methods The clinical data and pathological characteristics in 7 cases of bizarre leiomyoma of uterus were retrospectively analyzed. Results The main manifestations were hysterauxesis,irregular vaginal bleedirig,abdominal pain and pelvic mast. Light microscopy showed that parts of the cell nuclei were bizarre,accompanying with large or multiple nuclei in which rather big and reddish staining cloudy inclusion bodies were identified,and the mitotic figures were 1-2/10 high power field （HPF）. Conclusion Uterine bizarre leiomyoma is rare and its misdiagnosis rate is high,which pathologic diagnosis and differential diagnosis depend on HE slice observation. Uterine bizarre leiomyoma belongs to benign tumor in spite of its bizarre cell shape. Exairesis is the optimal treatment of uterine bizarre leiomyoma.