浅表宫颈阴道肌纤维母细胞瘤3例临床病理观察

Clinicopathological Observation of Three Patients with Superficial Cervicovaginal Myofibroblastoma

目的探讨浅表宫颈阴道肌纤维母细胞瘤(SCVM)的临床表现、组织病理学、免疫组化染色特点以及诊断。方法对3例(2例发生于阴道、1例发生于宫颈)SCVM的病理学形态、免疫组化染色进行观察,并复习相关文献。结果本组3例患者中,2例发生于绝经后妇女,中位年龄53岁,临床均表现为阴道出血。大体上,肿物成类圆形,边界清晰,肿物大小平均为4.3 cm。镜下见肿物由相对一致的梭形和星形细胞组成,周边区肿瘤细胞成分相对稀疏,中心区肿瘤细胞相对密集,细胞之间可见纤细、致密的胶原纤维。免疫组化染色示:Vimentin、Desmin、CD34、ER和PR阳性,SMA、S-100、CK和EMA阴性。Masson染色显示:肿瘤细胞呈红色,胶原纤维呈红色,纤维组织呈绿色。结论 SCVM是一种起源于女性阴道和宫颈黏膜下浅表基质的良性间叶性肿瘤,比较罕见,易与纤维上皮性息肉,血管肌纤维母细胞瘤等混淆,明确诊断需结合病理学形态、免疫组化及临床资料。

Objective To investigate the clinic features,histopathological staining and immunohistochemical stai-ning characteristics of superficial cervicovaginal myofibroblastoma（SCVM）,and to discuss the diagnosis and differential diagnosis. Methods Three patients with SCVM（2 patients vigina and 1 patient cervico）were evaluated by lightmi-croscopy and immunohistochemistry. Results Of the 3 patients,2 patients occurred in the postmenopausal women,the median age was 53 years old,the main clinical manifestations of vaginal bleeding. In general,the mass into a round shape,clear boundary,the average size of the tumor was 4. 3 cm. Histopathologically,SCVM were composed of uniform spindle and stellate cells,the tumor cells in the peripheral region were relatively sparse,and in the central region were relatively dense,the fine and dense collagen fibers were found between the tumor cells. The tumor cells were showed strong immune staining with vimentin,desmin,ER and PR,and focal reactivity with CD34,but SMA,S-100,CK and EMA were negative. Masson staining showed that the tumor cells and collagen fibers were red,and the fibers were green. Conclusion SCVM is very rare and it is a benign mesenchymal tumor arising within the superficial stroma of the vagina and cervix. SCVM is easy to be confused with fibroepithelial stroma polypand angio myofibroblastoma. A de-finitive diagnosis requires histopathological and immunohistochemical analyses.