摘要
【摘要】目的子宫内膜样腺癌伴性索样结构和玻璃样变是子宫内膜样腺癌的一种少见的组织学形态，易与子宫癌肉瘤等相混淆，通过认识此类肿瘤的临床病理学特征避免误诊。方法收集5例发生于子宫的内膜样腺癌伴性索样结构和玻璃样变的临床病理学资料，免疫组织化学染色采用过氧化物酶抗过氧化物酶复合物法，分析病变的组织学特征及临床病理学特点。结果5例患者的发病年龄为29—39岁（平均年龄33岁）。4例行子宫切除的患者中，3例国际妇产科联盟临床分期为ⅠA期、1例为ⅢC1期；另1例患者为刮宫术标本。5例肿瘤中均含有经典的内膜样腺癌成分，组织学分级4例为I级、1例为Ⅱ级，同时其10％～60％的区域含有性索样结构和玻璃样变的组织成分。性索样区的细胞为上皮样、纺锤形及梭形等细胞形态，其与内膜样腺癌一起可呈现出双相型分化的组织学特点，且内膜样腺癌区与性索样区具有不同的免疫组织化学特点。4例患者有随访资料，随访时间7—68个月（平均26．5个月），随访患者均无病生存。结论子宫内膜样腺癌伴性索样结构和玻璃样变具有独特的组织学特征，患者发病年龄较轻、预后较好，但性索样结构的发生机制有待进一步的研究。
Objective Endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus is a rare morphological variant of endometrioid carcinoma. The biphasic morphological features may cause confusion with carcinosarcoma of the uterus, leading to misdiagnosis. The aim of this article is to elucidate the clinicopathological characteristics of such endometrial carcinoma to avoid misdiagnosis. Methods The clinical and pathological data of 5 cases of endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus were collected and analyzed. Results The age of the 5 patients ranged from 29 to 39 years, with a mean age of 33 years. Four patients underwent surgery of radical hysterectomy, the other dilation and curettage biopsy. Among the former, 3 patients were at FIGO stage Ⅰ A, the other Ⅲ C1. Microscopically, all 5 tumors contained endometrioid carcinoma components, 4 of which were FIGO grade Ⅰ , the remaining one was grade Ⅱ. Each tumor was of variable proportions of corded and hyalinized areas ranging from 10% to 60%. The cells in the corded and hyalinized areas were epithelioid, fusiform and spindle in morphology, admixed with the endometrioid carcinoma component, resulting in a biphasic pattern. The corded and hyalinized component exhibited distinctively different immunophenotypical feature from that by the conventional endometrioid carcinoma component. The results of follow-up for 4 patients of 7 to 68 months （ mean = 26. 5 months） revealed that all patients were alive without recurrence of the malignancy. Conclusions Endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus presents unique morphology, and the patients are usually young with relatively favorable prognosis. The definite mechanism for the pathogenesis of the sex cord-like formations and hyalinization needs further investigation.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2016年第5期297-301,共5页
Chinese Journal of Pathology
关键词
子宫内膜样腺癌
性索样结构
玻璃样变
癌肉瘤
Endometrioid carcinoma
Sex cord-like formations
Hyalinization
Carcinosarcoma
