复发性青春期子宫腺肉瘤临床病理特征

Clinicopathologic characteristics of the recurrent uterine adenosarcoma in adolescence

目的探讨与青春期子宫腺肉瘤复发相关的病理特征及免疫表型。方法对1例青春期子宫腺肉瘤原发及盆腔复发肿瘤进行形态学及免疫组织化学观察，并复习相关文献讨论。结果原发肿瘤与复发肿瘤均由良性腺体和肉瘤性间质混合组成，原发肿瘤肉瘤成份为子宫内膜间质肉瘤，并伴有肉瘤性过度生长及子宫肌层浸润；复发肿瘤与原发肿瘤相比除具有更多的肉瘤性过度生长区域外，同时具有异源性软骨肉瘤成份；免疫组化结果显示原发肿瘤肉瘤性间质细胞p53阳性，Ki-67阳性率大于70％，ER和PR均阴性。结论肉瘤性过度生长、子宫肌层浸润、表达p53、高表达Ki-67及ER、PR表达的缺失可能作为评估青春期子宫腺肉瘤复发性的病理特征及免疫表型因素。

Objective To investigate the pathological features and immtmophenotype which were related to recurrence of the uterine adenosarcoma in adolescence. Methods The primary and recurrent uterine adenosarcoma in an adolescence were observed by morphology and immunohistechemistry. The related literatures were reviewed. Results The primary and recurrent tumor both were composed of an admixture of benign - appearing glands and a sareomatous stroma. The sareomatous stroma in primary tumor constructed by endometrial stromal sarcoma with sareomatous overgrowth and had myometrial invasion. Recurrent tumor possessed more sareomatous area and had chondrosareoma compared with primary tumor. Immunohistochemically ,the sarcomatous stroma cells in primary tumor： p53 （ ＋ ）, Ki -67 （ 〉 70%, ＋ ）, ER （ - ）, PR （ - ）. Conclusion The pathological features and immunophenotype related to recurrence may be sarcomatous overgrowth, myometrial invasion, immunohistochemical stain positive for p.53, strongly positive for Ki -67 and negative for ER, PR.