卵巢子宫内膜样间质肉瘤临床病理观察

Endometrioid stromal sarcoma of the ovary： a clinicopathologic study

目的探讨卵巢子宫内膜样间质肉瘤的发生机制、临床病理特征、诊断与鉴别诊断及预后。方法对1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生期子宫内膜间质细胞的小细胞组成，瘤细胞呈卵圆形或短梭形，胞浆稀少，肿瘤细胞呈漩涡状围绕似子宫内膜螺旋小动脉的厚壁小血管。免疫组化示瘤细胞表达Vimentin和CD10，不表达Calretinin，α-inhibin，H—caldesmon，CD99，CD117，CD34，desmin，SMA and CK（AE1／AE3）。结论卵巢子宫内膜样间质肉瘤在临床为一惰性生长的恶性肿瘤，非常罕见。其鉴别诊断主要包括子宫内膜间质肉瘤累及卵巢（直接侵犯或转移）和卵泡膜细胞一纤维瘤。

Objective To investigate the pathogenesis, clinicopathological characteristics, diagnosis, differential diagnosis and prognosis of endometrioid stromal sarcoma of the ovary. Methods One case of endometrioid stromal sarcoma of the ovary was studied with HE and immunohistochemical Envision staining. The related literatures were reviewed. Results The tumor＇ s histological and immunophenotype were similar to those of endometrial stromal sarcoma of the uterus. The tumor was composed of short spindle cells resembling those of proliferative endometrial stroma. Small vessels resembling endometrial spiral arteriole, which were surrounded by whirlpool -form tumor cells,were easily found. The tumor cells were positive for vimentin and CD10,and negative for Calretinin, α - inhibin, H - caldesmon, CD99, CD117, CD34, desmin, SMA and CK （ AE1/AE3 ）. Conclusion Endometrioid stromal sarcoma of the ovary is a clinically indolent malignant tumor which is extremely raze. Its main differential diagnosis should include invasion or metastasis of endometrial stromal sarcoma and thecofibroma.