CAJ | 학술논문

目的：探讨子宫颈腺肉瘤的临床和病理特征、免疫表型、诊断及鉴别诊断。方法：总结本病例临床病理资料及复习相关文献，分析该病例的组织病理学特征、免疫组化特征和特殊染色等。结果：子宫颈腺肉瘤多数患者表现为异常的阴道流血、宫颈息肉或者复发性息肉、阴道排液等，临床和病理上易与良性的宫颈息肉相混淆。本例患者表现为异常阴道出血和阴道排液，子宫颈管增粗。镜下见肿瘤由良性上皮和恶性间叶成分组成，良性的上皮成分多为子宫内膜样腺体，间叶成分呈肉瘤样改变。免疫组化肿瘤间质细胞 CK（－）、CKL（－）、CKH（－）、SMA（－）、Desmin（－）、CD10（－）、S －100（－）、HMB45（－）、网状纤维染色可证实其肉瘤成分，PTAH 染色未见横纹，良性腺体成分 CK 和 CKL 阳性。结论：子宫颈腺肉瘤少见，易误诊，病理形态观察、免疫组化染色及特殊染色对诊断及鉴别诊断有重要意义，其治疗及预后还有待更多病例的长期随访。
목적：탐토자궁경선육류적림상화병리특정、면역표형、진단급감별진단。방법：총결본병례림상병리자료급복습상관문헌，분석해병례적조직병이학특정、면역조화특정화특수염색등。결과：자궁경선육류다수환자표현위이상적음도류혈、궁경식육혹자복발성식육、음도배액등，림상화병리상역여량성적궁경식육상혼효。본례환자표현위이상음도출혈화음도배액，자궁경관증조。경하견종류유량성상피화악성간협성분조성，량성적상피성분다위자궁내막양선체，간협성분정육류양개변。면역조화종류간질세포 CK（－）、CKL（－）、CKH（－）、SMA（－）、Desmin（－）、CD10（－）、S －100（－）、HMB45（－）、망상섬유염색가증실기육류성분，PTAH 염색미견횡문，량성선체성분 CK 화 CKL 양성。결론：자궁경선육류소견，역오진，병리형태관찰、면역조화염색급특수염색대진단급감별진단유중요의의，기치료급예후환유대경다병례적장기수방。
Objective:To investigate the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of primary cervical adenosarcoma.Methods:To review the relevant literatures,analyze the clinical features, pathohistology,immunohistochemistry and special staining of the patients.Results:Clinically,abnormal vaginal bleed-ing,cervical polyps or recurrent polyps,and abnormal vaginal discharge can be observed in most cervical adenosarco-ma patients.It may be mixed up with benign cervical polyp easily.The patient that we met showed abnormal vaginal bleeding ,vaginal discharge,and an enlarged cervix.Microscopically,the mass was composed of a mixed proliferation of epithelial and stromal cells.The epithelial elements were glands of benign endometrial type.CK and CKL was posi-tive.The stromal elements were sarcomatoid tissues.Immunohistochemistry of sarcomatoid cells,CK,CKL,CKH, SMA,Desmin,CD10,S -100 and HMB45 were all negative.The sarcoma component was also confirmed by reticular fiber staining.PTAH staining showed no stripes in the cytoplasm of sarcomatoid cells.Conclusion:Mullerian adeno-sarcoma is a rare neoplasm of uterine cervix,often misdiagnosed.Pathologic morphology,immunohistochemistry and special stains are important for its diagnosis and differential diagnosis.Long -term follow -up of more cases is needed and benefit for us understanding its treatment and prognosis.