子宫上皮样平滑肌瘤的临床病理观察

A clinicopathological study on uterine epithelioid leiomyoma

目的 探讨子宫上皮样平滑肌瘤 (epithelioidleiomyoma ,EL)的临床病理特征和生物学特性。 方法 收集 14例子宫EL的临床和病理资料。随机抽取同期 10例子宫低度恶性间质细胞肉瘤作为对照 .。采用二步法进行actin、Des、EMA和CD10免疫组化染色。结果 子宫EL临床表现无特征性。镜下显示肿瘤细胞呈类似上皮细胞样的圆形、卵圆形或多边形 ,核呈圆形或卵圆形 ,胞质嗜伊红染色或部分伴空泡化改变似核周晕 ,也可表现为富含糖原的透明细胞。平均核分裂象 0～ 1个 /10HPF。 14例EL的actin、Des全部阳性表达 ,EMA9例阳性 ,CD10有 2例呈弱阳性。 10例子宫低度恶性间质细胞肉瘤actin、Des、EMA和CD10分别有 5例、3例、2例和 7例阳性表达。结论 子宫EL有特殊的病理形态特征 ;免疫组化有助于鉴别诊断。

Purpose To investigate the clinicopathological and biological features of the uterine epithelioid leiomyoma(EL). Methods Clinical and pathological data of 14 patients of EL were analyzed. Ten patients of low grade endometrial stromal sarcoma(ESS) were randomly selected as control. Immunohistochemical staining for actin?Des?EMA and CD10 was carried out with the two step method. Results No special clinical features were evident. Microscopically, the tumor composed of epithelioid cells such as round, oval or polymorphic cells with oval or round nuclei, with eosinophilic cytoplasm and a usually slight degree of cytoplasmic vacuolation, some by clear cytoplasm with abundant glycogen. The average mitotic figures were 0 1/10HPF. Among 14 EL cases, all were positive for actin and Des, 9 positive for EMA, 2 weakly positive for CD10. In 10 cases of low grade ESS, 5 of which were detected positive expression for actin, 2 for EMA , 3 for Des and 7 for CD10 respectively. Conclusions EL has distinct pathological features. Immunohistochemistry is helpful in the differential diagnosis of EL.