11例低度恶性子宫内膜间质肉瘤的病理诊断与鉴别诊断

Pathological and differential diagnosis for low gradeendometrial stromal sarcoma (LGESS)

目的 :探讨低度恶性子宫内膜间质肉瘤的临床病理学特点及鉴别诊断。方法 :收集11例低度恶性子宫内膜间质肉瘤 ,复习病历档案进行随访 ,同时观察其临床病理特点 ,并作免疫组化染色分析。结果 :所有肿瘤具有低度恶性子宫内膜间质肉瘤的临床及组织学特征 ,其中3例伴性索样成份 ,患者年龄为31～60岁 ,平均39岁。10例患者随访健在 ,其中3例带瘤存活。结论 :低度恶性子宫内膜间质肉瘤 ,高发年龄为40岁左右 ,它是一种低度恶性或潜在恶性的肿瘤 ,诊断上应与富细胞性平滑肌瘤 ,静脉内平滑肌瘤病 ,子宫类似卵巢性索肿瘤 。

Objective:To investigate the clinicopathologic features of low grade endometrial stromal sarcoma (LGESS) and its differential diagnosis.Methods:Eleven cases of LGESS were analyzed by means of reviewing the history records,observing on both HE and immunohisto chemical staining.The clinicopathological features of the LGESS were studied and these cases were followed up.Results:Under microscope these tumors all have the histopathological characteristics of LGESS,three of them contain the components of sex cord like differentiation.Patients' ages ranged from 31 to 60 years old(average 39).Ten cases were still alive in a period of 1～11 years after diagosis,three of them survived with tumors until now.Conclusion:Peak age of incidence for LGESS is about 40.It is low grade malignant or potentially malignant.It should be distinguished from leiomyoma with abundant cells,intravenous leiomyoma,UTROSCTs and Mullerian adenosarcoma.