摘要
目的 探索鉴别子宫高度富于细胞平滑肌瘤与子宫内膜间质肿瘤的形态和免疫组织化学特点及其在鉴别诊断中的意义。方法 采用光镜观察和免疫组织化学EnVision法染色对 2 0例子宫高度富于细胞平滑肌瘤、2 1例内膜间质肿瘤和 1例间质肌瘤进行组织病理学分析。结果 高度富于细胞平滑肌瘤肿瘤细胞致密 ,细胞呈圆形、梭形 ,胞质少 ,与邻近的正常肌壁平滑肌细胞有移行。所有病例都可见到成束分布的肿瘤细胞灶。大的厚壁血管明显可见 ,部分病例中可见裂隙。子宫内膜间质肿瘤肿瘤细胞则与增生期子宫内膜的间质细胞非常相似 ,螺旋状小动脉散布其间。 2 0例低度恶性间质肉瘤肿瘤组织呈舌状侵入邻近肌壁。免疫组织化学显示高度富于细胞平滑肌瘤h caldesmon、calponin、CD10、结蛋白及平滑肌肌动蛋白 (SMA)的阳性率分别为 80 0 % (16 / 2 0 )、10 0 %(2 0 / 2 0 )、0 (0 / 2 0 )、95 0 % (19/ 2 0 )及 10 0 % (2 0 / 2 0 ) ,而子宫内膜间质肿瘤相应的阳性率则为 4 7% (1/2 1)、2 3 8% (5 / 2 1)、6 6 7% (14/ 2 1)、2 3 8% (5 / 2 1)及 19 0 % (4 / 2 1) ,这些抗体在两组肿瘤间的表达差异有显著性 (P =0 0 0 1)。结论 子宫高度富于细胞平滑肌瘤具有特殊形态特点 ,免疫组织化学h caldesmon、calponin、CD10、结?
Objective To study the morphological characteristics and immunophenotype of highly cellular leiomyoma (HCL) of uterus, compared with that of uterine endometrial stromal tumors (EST). Methods HE and immuno-stained sections EnVision method from 20 cases of HCL, 21 cases of EST and 1 case of stromomyoma were reviewed. Monoclonal antibodies against h-caldesmon, calponin, CD10, desmin and smooth muscle actin (SMA) were used for immunohistochemistry studies. Results On microscopic examination, HCL were densely cellular and composed of cells that ranged from spindle-shaped to round with scanty cytoplasm. A focal fascicular pattern was present in all cases. Blood vessels with large, thick muscular walls were a conspicuous feature of the majority of tumors. Cleft-like spaces were present in 9 tumors and 15 cases exhibited irregular focal extensions into the adjacent myometrium. ESTs were composed of cells that resembled endometrial stromal cells of proliferative endometrium. These cases included a significant component of delicate blood vessels similar to spiral arterioles. All 20 low grade endometrial stromal sarcoma cases had infiltrative growth to adjacent myometrium. Immunoreactivities of HCL for h-caldesmon, calponin, CD10, Desmin and SMA were 80.0%(16/20), 100%(20/20), 0(0/20), 95.0%(19/20) and 100%(20/20),respectively, whereas the positive rates of EST were 4.7%(1/21), 23.8%(5/21), 66.7%(14/21), 23.8%(5/21) and 19.0%(4/21), respectively (P=0.001). Conclusions Highly cellular leiomyomas have distinct morphologic features. H-caldesmon, calponin, CD10, desmin and SMA are helpful in the differential diagnosis of HCL and EST.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2002年第5期396-400,共5页
Chinese Journal of Pathology
