子宫内膜间质肉瘤伴多成分分化

Endometrial stromal sarcoma with multi-differentiation:a study of 17 cases

目的 探讨子宫内膜间质肉瘤伴多成分分化的临床、病理特征 ,及其鉴别诊断及预后的意义。方法 观察 17例子宫内膜间质肉瘤的组织形态 ,部分病例辅以免疫组织化学染色或电镜观察。结果 13例低度恶性及 4例高度恶性子宫内膜间质肉瘤表现多成分分化 ,其中 13例伴性索样分化 ,10例伴平滑肌分化 ,2例伴骨分化 ,1例伴横纹肌分化 ,有 9例同时伴 2种多成分分化。结论 无论低度恶性或高度恶性的子宫内膜间质肉瘤均可伴多成分分化 ,以性索样分化与平滑肌分化最常见 ,少见伴骨分化或横纹肌分化。子宫内膜间质肉瘤的预后与多成分分化的数量及类型关系不大。

Objective To investigate the clinical and pathomorphological features of multi-differentiated endometrial stromal sarcoma of the uterus and to discuss their behaviour and differential diagnosis. Methods The histological characteristics of all cases were observed by pathological examination, some of them have been studied by immunohistochemical and/or ultrastructural techniques. Results Multi-differentiation was present in 13 cases of low grade and 4 cases of high grade endometrial stromal sarcoma, of which, 13 cases had sex-cord differentiation, 10 cases had smooth muscle differentiation, osseous differentiation in 2 cases and striated muscle differentiation in 1case. Two types of multi-differentiation was present in 9 cases. Conclusions Both low-grade and high-grade endometrial stromal sarcoma of uterus can display multi-differentiation. Sex-cord and smooth muscle differentiation are the most common types. Osseous and striated muscle differentiation are very rare. There is no definite correlation between prognosis and the amount or types of multi-differentiation components.