子宫内膜小细胞癌伴内膜样腺癌临床病理观察

CLINICAL PATHOLOGY OF SMALL-CELL CARCINOMA OF ENDOMETRIUM ASSOCIATED WITH ENDOMETRIOID ADENOCARCINOMA

目的探讨子宫内膜小细胞癌伴内膜样腺癌的临床病理特点及预后。方法对子宫内膜小细胞癌伴内膜样腺癌的组织学和免疫组化及临床病理特点结合文献进行分析。结果原发性子宫内膜小细胞癌伴发内膜样腺癌非常罕见,瘤细胞小,呈巢状、索状或团状排列,易与子宫内膜间质肉瘤、恶性中胚叶混合瘤、恶性淋巴瘤混淆,免疫组化显示小细胞突触素、嗜铬粒素A、神经特异性烯醇化酶均呈阳性表达。结论子宫内膜小细胞癌伴内膜样腺癌恶性度高、预后差,病人多于1年内死于远处转移。

Objective To explore clinicopathological features and prognosis of small-cell carcinoma of endometrium （SCCE） associated with endometrioid adenocarcinoma （EA）. Methods The hitological, immunohistochemical, and clinicopathological features of SCCE associated with EA were analyzed in associated with literatures. Results Primary SCCE associated with EA was rare. Its cells were small, showing as nest, cord, or group. It was easy to be confused with endometrial stromal sarcoma, malignant mesoblast mixed tumor, and malignant lymphoma. Immunohistochemically, positive synaptophysin, chromogranin-A, and neuron specific enolase were present. Conclusion SCCE associated with EA is highly malignancy and poor prognosis. Most patients with this malignancy die of distant metastasis within one year.