子宫和卵巢腺瘤样瘤的临床病理分析

Clinical pathological analysis of adenomatoid tumor in uterus and ovaries

目的 探讨女性生殖系统腺瘤样瘤的发生、免疫组织化学表达的特征及鉴别诊断。方法 对 2 4例子宫和卵巢腺瘤样瘤进行临床病理及免疫组织化学观察。结果 2 4例患者中腺瘤样瘤发生于子宫者 2 1例 ,卵巢者 2例 ,子宫与卵巢同时发生者 1例 ,分别占本院同期子宫及卵巢肿瘤及瘤样病变的 0 .34 %和 0 .0 6 %。免疫组织化学染色显示 :波形蛋白及细胞角蛋白 (AE1/AE3 )均为阳性 ,呈双相表达 ;第八因子相关抗原 (FⅧRAg)均为阴性 ;S 10 0蛋白 2 0例阳性 (83.3% ) ,上皮膜抗原 (EMA) 4例阳性 (16 .7% ) ;其中 10例行calretinin蛋白染色 ,均为阳性表达。结论 女性生殖系统腺瘤样瘤为间皮起源 ,子宫为最常见部位。免疫组织化学染色结果可作为诊断及鉴别诊断的重要参考依据。其生物学行为为良性 ,预后良好。

Objective To study the immunohistochemical feature and the differential diagnosis of adenomatoid tumors in uterus and ovaries. Methods Clinical pathological analysis and immunohistochemical studies were performed on 24 cases of adenomatoid tumors in the uterus and ovaries. Results Of the 24 cases, 21 cases were in the uterus, 2 cases in the ovaries and 1 cases in both the uterus and the ovary. Grossly, the mean diameter of the 22 uterus tumors was 2.2 cm, ranging from 0.2～5.5 cm. 14 (63.6%) were located in the subserosa or near by the subserosa of the uterine cornua. The other 8 tumors located in the myometrium. The cut surface presented a nodular pattern with grayish white or yellowish in color, partially cystic. 3 ovarian tumors became all cystic, without a clear cut margin from the surroundings. Microscopically, the tumor consisted of various gland like structure or luminal spaces lined with flat, cuboidal or low columnar cells, similar to blood vessels in structure. Among the tumor cells, there were scattered vesicular cells with large or small vacuoles, but no nuclear atypia and mitotic figures detected. Immunohistochemical staining showed the tumor cells positive for vimentin, AE 1/AE 3 and calretinin, but negative for F VIII Rag. S 100 and EMA were positive in 20 (83.3%) and 4 (16.7%) cases respectively. Conclusion Adenomatoid tumor of the female genital tract is mesothelial in origin and uterus was considered as the most common site of occurance Immunohistochemcal phenotypes can be used as an important evidence for differential diagnosis. The biological behavior of adenomatoid tumor is benign and with a good prognosis.