腹膜播散性平滑肌瘤病6例临床病理分析

Peritoneal disseminated leiomyomatosis:a clinicopathological analysis of six cases

目的通过分析临床病理特征,提高对腹膜播散性平滑肌瘤病(LPD)的认识,为临床诊治提供帮助。方法本文回顾性分析本院术后病理确诊的6例LPD患者,结合文献复习其临床特征及病理组织学等特点。结果患者均有子宫肌瘤切除既往史,且本次术后病理均符合腹膜播散性平滑肌瘤病。免疫组化结果:SMA、H-caldesmon均为阳性;ER和PR为弥漫阳性;Ki-67指数平均为4%(值域:1%~8%)。结论LPD的确诊需结合临床及病理特征,提示临床工作中应尽量减少因医源性因素导致LPD发生的可能,且对于术后病理亚型为富于细胞型的子宫平滑肌瘤应加强随访。

Objective Our study aimed to understand better leiomyomatosis peritonealis disseminate(LPD)by analyzing clinical and pathological features to assist in clinical diagnosis and treatment.Methods We reviewed six LPD cases at Beijing Chaoyang Hospital,Capital Medical University,and analyzed their clinical features,pathology,and immunohistochemistry.Results All patients had a history of uterine fibroid resection,and the postoperative pathology was consistent with peritoneal disseminated leiomyomatosis.Immunohistochemical result:SMA and H-caldesmon were positive;ER and PR were diffusely positive;The average Ki67 index was 4%(range:1%-8%).Conclusion The diagnosis of LPD needs to be based on history,intraoperative exploration,and postoperative pathological result.In our clinical work,iatrogenic spread due to myomectomy needs be minimized,and follow-up needs be strengthened for uterine leiomyoma with a cellular subtype.