国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2009年
16期
7-13
,共7页
雷伟华%梁秀莲%谭敏华%梁宏%简乐乐%胡志雄%邹绮嫦%成卓梅%邓超桦%刘丽萍
雷偉華%樑秀蓮%譚敏華%樑宏%簡樂樂%鬍誌雄%鄒綺嫦%成卓梅%鄧超樺%劉麗萍
뢰위화%량수련%담민화%량굉%간악악%호지웅%추기항%성탁매%산초화%류려평
子宫肿瘤%细胞分化%诊断%鉴别
子宮腫瘤%細胞分化%診斷%鑒彆
자궁종류%세포분화%진단%감별
Utenine neoplasms%Cell differentiation%Diagnosis%Differentiate
目的 探讨低度恶性子宫内膜间质肉瘤(LGESS)分化特性与病理诊断、鉴别诊断.方法 应用免疫组化染色对11例LGESS进行Vim、CD10、ER、PR、CD99、Iinhibin、CK、EMA、Des、SM、CD117、CD34等抗体成分检测,分析瘤组织分化特性与病理诊断、鉴别诊断关系.结果 临床表现停经后阴道流血6例,月经增多3例、下腹痛2例.肿瘤直径2~10cm,6例息肉样突入宫腔,5例肌间结节状.镜下瘤组织南梭形细胞构成,弥漫束状排列,类似正常增殖期子宫内膜间质细胞,呈舌状浸润性生长,可见丛状分布薄壁螺旋动脉样血管,核分裂数<10个/10HPF,可见泡沫细胞.伴有平滑肌、性索样分化各3例,经典型、腺样分化各2例,混合型1例.免疫组化:Vim(11/11)、CD10(10/11)、PR(8/11)、ER、SM(7/11)、CK(6/11)、EMA、Des、S-100(3/11)、CD99、Iinhibin (2/11)、CD117、CD34、LCA均阴性.结论 LGESS是一种以梭形细胞为主,类似增殖期子宫内膜间质细胞肿瘤,可以向平滑肌、性索样等组织分化.多向分化特性致使瘤组织形态易误诊为平滑肌肿瘤、低分化子宫内膜腺癌.结合临床,免疫组化有助于病理诊断.
目的 探討低度噁性子宮內膜間質肉瘤(LGESS)分化特性與病理診斷、鑒彆診斷.方法 應用免疫組化染色對11例LGESS進行Vim、CD10、ER、PR、CD99、Iinhibin、CK、EMA、Des、SM、CD117、CD34等抗體成分檢測,分析瘤組織分化特性與病理診斷、鑒彆診斷關繫.結果 臨床錶現停經後陰道流血6例,月經增多3例、下腹痛2例.腫瘤直徑2~10cm,6例息肉樣突入宮腔,5例肌間結節狀.鏡下瘤組織南梭形細胞構成,瀰漫束狀排列,類似正常增殖期子宮內膜間質細胞,呈舌狀浸潤性生長,可見叢狀分佈薄壁螺鏇動脈樣血管,覈分裂數<10箇/10HPF,可見泡沫細胞.伴有平滑肌、性索樣分化各3例,經典型、腺樣分化各2例,混閤型1例.免疫組化:Vim(11/11)、CD10(10/11)、PR(8/11)、ER、SM(7/11)、CK(6/11)、EMA、Des、S-100(3/11)、CD99、Iinhibin (2/11)、CD117、CD34、LCA均陰性.結論 LGESS是一種以梭形細胞為主,類似增殖期子宮內膜間質細胞腫瘤,可以嚮平滑肌、性索樣等組織分化.多嚮分化特性緻使瘤組織形態易誤診為平滑肌腫瘤、低分化子宮內膜腺癌.結閤臨床,免疫組化有助于病理診斷.
목적 탐토저도악성자궁내막간질육류(LGESS)분화특성여병리진단、감별진단.방법 응용면역조화염색대11례LGESS진행Vim、CD10、ER、PR、CD99、Iinhibin、CK、EMA、Des、SM、CD117、CD34등항체성분검측,분석류조직분화특성여병리진단、감별진단관계.결과 림상표현정경후음도류혈6례,월경증다3례、하복통2례.종류직경2~10cm,6례식육양돌입궁강,5례기간결절상.경하류조직남사형세포구성,미만속상배렬,유사정상증식기자궁내막간질세포,정설상침윤성생장,가견총상분포박벽라선동맥양혈관,핵분렬수<10개/10HPF,가견포말세포.반유평활기、성색양분화각3례,경전형、선양분화각2례,혼합형1례.면역조화:Vim(11/11)、CD10(10/11)、PR(8/11)、ER、SM(7/11)、CK(6/11)、EMA、Des、S-100(3/11)、CD99、Iinhibin (2/11)、CD117、CD34、LCA균음성.결론 LGESS시일충이사형세포위주,유사증식기자궁내막간질세포종류,가이향평활기、성색양등조직분화.다향분화특성치사류조직형태역오진위평활기종류、저분화자궁내막선암.결합림상,면역조화유조우병리진단.
Objective Discusses between the low-grade endometrial stromal sarcoma(LGESS) differentiation characteristic and the pathological diagnosis,the differentiate diagnosis.Methods The application immunohistochemical on immune body ingredient examinations and so on the Vim, CD10,ER,PR ,CD99,inhibin,CK,EMA,Des,SM,CD117,CD34 to 11 example LGESS,the analysis lump tissue differentiation characteristic and the pathological diagnosis,the differentiate diagnosis relations.Results After the clinical manifestation menopause the vagina bleeds 6 examples,the menstruation increases 3 examples,the hypogastralgia 2 examples.The tumor diameter 2cm-10cm,6 example polyp type penetrates the palace cavity,5 example intermusculars tie the nodular.Under the mirror the lump organization by the spindle-shaped cell constitution,fills the air ties the shape arrangement,the similar normal period of growth endometrium intersititial cell,assumes the tongue wetting quality to grow,the obvious fasciculate distribution thin wall spiral artery type blood vessel,the nuclear fission counts<10/10HPF,obvious froth cell.Is accompanied by the smooth muscle,the rope type splits up each 3 examples,after the model,the adenoid splits up each 2 examples,the mixed 1 example.Immunohistochemistry:Vim(11/11),CD10(10/11),PR(8/11),ER,SM (7/11),CK(6/11),EMA,Des,S-100(3/11),CD99,Inhibin(2/11),CD117,CD34,LCA even negative.Conclusions LGESS is one kind by the spindle-shaped cell primarily,the similar period of growth endometrium intersititial celt tumor,may to the smooth muscle,tissue differentiations and so on rope type.Many easy to misdiagnose to the split up characteristic cause lump organization shape for the smooth muscle tumor,the low score beggar palace internal membrane gland cancer.Unifies clinically,the immunohistochemical stain is helpful to the pathological diagnosis.