中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
11期
76-78
,共3页
卵巢%子宫内膜样间质肉瘤%鉴别诊断
卵巢%子宮內膜樣間質肉瘤%鑒彆診斷
란소%자궁내막양간질육류%감별진단
Ovary%Endometroid stromal sarcoma%Differential diagnosis
目的 探讨卵巢子宫内膜样间质肉瘤的临床病理特点、免疫组织化学表现及鉴别诊断.方法 收集2004年至2013年5例卵巢子宫内膜样间质肉瘤的临床病理及随访资料,进行光镜观察及免疫组织化学染色,并对相关文献进行复习.结果 5例患者发病年龄52～70岁,平均58.1岁.单侧卵巢4例(3例右侧,1例左侧),双侧1例.病变大体表现为实性结节(4例)及囊实性肿块(1例),肿块大小1.5 ～6.0 cm,平均3.2 cm,实性区域切面灰黄,其中1例伴有明显的出血,囊实性肿块中的囊腔内见血性物.镜下见弥漫生长的圆形或卵圆形小细胞包绕细网状小动脉呈纤维瘤样、席纹状或结节状排列,其中1例呈不显著玻璃样变性,另1例可见平滑肌样分化,2例可见泡沫样细胞.这些病例均细胞异型性较小,核分裂像1～6/10 HPF.5例均可见卵巢子宫内膜异位.免疫组织化学:CD10阳性5例,PR阳性4例,S-100阳性3例,CD99阳性3例.3例患者有随访资料,2例失访.结论 原发于卵巢的子宫内膜样间质肉瘤是一种罕见的卵巢肿瘤,具有与子宫内子宫内膜间质肉瘤相似的病理组织学特点及免疫组织化学结果,诊断需谨慎.
目的 探討卵巢子宮內膜樣間質肉瘤的臨床病理特點、免疫組織化學錶現及鑒彆診斷.方法 收集2004年至2013年5例卵巢子宮內膜樣間質肉瘤的臨床病理及隨訪資料,進行光鏡觀察及免疫組織化學染色,併對相關文獻進行複習.結果 5例患者髮病年齡52～70歲,平均58.1歲.單側卵巢4例(3例右側,1例左側),雙側1例.病變大體錶現為實性結節(4例)及囊實性腫塊(1例),腫塊大小1.5 ～6.0 cm,平均3.2 cm,實性區域切麵灰黃,其中1例伴有明顯的齣血,囊實性腫塊中的囊腔內見血性物.鏡下見瀰漫生長的圓形或卵圓形小細胞包繞細網狀小動脈呈纖維瘤樣、席紋狀或結節狀排列,其中1例呈不顯著玻璃樣變性,另1例可見平滑肌樣分化,2例可見泡沫樣細胞.這些病例均細胞異型性較小,覈分裂像1～6/10 HPF.5例均可見卵巢子宮內膜異位.免疫組織化學:CD10暘性5例,PR暘性4例,S-100暘性3例,CD99暘性3例.3例患者有隨訪資料,2例失訪.結論 原髮于卵巢的子宮內膜樣間質肉瘤是一種罕見的卵巢腫瘤,具有與子宮內子宮內膜間質肉瘤相似的病理組織學特點及免疫組織化學結果,診斷需謹慎.
목적 탐토란소자궁내막양간질육류적림상병리특점、면역조직화학표현급감별진단.방법 수집2004년지2013년5례란소자궁내막양간질육류적림상병리급수방자료,진행광경관찰급면역조직화학염색,병대상관문헌진행복습.결과 5례환자발병년령52～70세,평균58.1세.단측란소4례(3례우측,1례좌측),쌍측1례.병변대체표현위실성결절(4례)급낭실성종괴(1례),종괴대소1.5 ～6.0 cm,평균3.2 cm,실성구역절면회황,기중1례반유명현적출혈,낭실성종괴중적낭강내견혈성물.경하견미만생장적원형혹란원형소세포포요세망상소동맥정섬유류양、석문상혹결절상배렬,기중1례정불현저파리양변성,령1례가견평활기양분화,2례가견포말양세포.저사병례균세포이형성교소,핵분렬상1～6/10 HPF.5례균가견란소자궁내막이위.면역조직화학:CD10양성5례,PR양성4례,S-100양성3례,CD99양성3례.3례환자유수방자료,2례실방.결론 원발우란소적자궁내막양간질육류시일충한견적란소종류,구유여자궁내자궁내막간질육류상사적병리조직학특점급면역조직화학결과,진단수근신.
Objective To study the clinicopathologic features,immunophenotype and differential diagnosis of endometrioid stromal sarcoma of the ovary.Methods Clinicopathologic and follow-up data of five cases of endometrioid stromal sarcoma of the ovary from 2004 to 2013 were collected and reviewed.Immunohistochemical staining was performed.Results Five patients' age ranged from 52 to 70 years (average 58.1 years).The tumors were unilateral in 4 cases (3 cases of right side,1 case of left side) and bilateral in 1 case.The masses were solid(4 cases),solid and cystic(1 case),ranged from 1.5 to 6.0 (mean 3.2) cm.The solid areas typically had a tan-yellow cut surface,with areas of hemorrhage noted in 1 case.Blood was present in the cyst lumens.On microscopic examination,the predominant pattern was a diffuse growth of small round or oval cells wih interspersed arterioles.Fibromatous,nodular and storiform growth could be observed,unconspicuous hyaline plaques was present in 1 case.Smooth muscle differentiation was seen in 1 case.Foam cells were present in 2 cases.The tumors showed minimal cytologic atypia.The mitotic index ranged from 1 to 6/10 high-power fields(HPF).Ovarian endometriosis was associated with the tumor in all 5 cases.Immunhistochemical study showed that all of the 5 cases were positive for CD10.Four cases expressed PR.S-100 and CD99 could be detected in 3 cases.Followup information was available for 3 patients,2 patients were lost to follow-up.Conclusions Primary endometrioid stromal sarcoma of the ovary is a rare ovary tumor.Its histologic features and immunohistochemical results are similar to uterine endometrial stromal sarcoma.The diagnosis shoule be made cautiously given its rarity.
