子宫内膜间质肿瘤12例病理分析

Clinicopathologic study of 12 cases of endometrial stromal neoplasms

目的 总结子宫内膜间质肿瘤的病理学特点 ,讨论其诊断标准。方法 运用组织病理学、免疫组织化学方法并结合 12例患者随访材料。结果 肿瘤的大体形态有 3种 :宫腔内呈息肉状、肌壁间结节状及脉管中蚯蚓状。肿瘤的镜下特点 :子宫内膜间质结节 ( ESN)和低度恶性子宫内膜间质肉瘤 ( L GESS)组织学表现相似。二者鉴别要点在于 L GESS具有浸润性生长和脉管内生长的特性。L GESS和高度恶性子宫内膜间质肉瘤 ( HGESS)的鉴别要点是后者具明显异型性。

Objective To summarize the pathologic characteristics of endometrial stromal neoplasms and discuss its diagnostic criteria.Methods Twelve cases of endometrial stromal neoplasms were studied by histopathology immunohistochemistry and clinical follow up.Results There are three types of gross appearances:polypoid lession、nodulous masses and wormlike appearance in which it protrude to dilated vascular spaces.Microscopic appearance showed that endometrial stromal nodule (ESN) is histologically identical to low grade endometrial stromal sarcoma (LGESS).But LGESS possesses infiltrating margins and vascular invasion.Significant anaplasia is a feature of high grade endometrial stromal sarcoma (HGESS).Conclusions Whether presence of myoinvasion and/or vascular invasion and morphologic heterogeneity is the pre request to define the feature of this tumor,and to exclude of other malignant tumor.