摘要
目的 :探讨子宫非典型性息肉状腺肌瘤 (APA)的临床病理特征及其鉴别诊断。方法 :收集 6例子宫非典型性息肉状腺肌瘤 ,综合分析其临床表现 ,并进行光镜观察。结果 :患者年龄 2 7～ 6 5岁 ,平均 43 1岁。主要以阴道不规则出血和 (或 )不孕症为主诉。除 1例部位不详外 ,2例发生在宫底 ,2例宫体下段 ,1例位于宫颈管内。光镜下表现为腺上皮呈不同程度的增生 ,并伴有一定异型性 ,1例出现鳞化灶 ;肿瘤间质可见增生的平滑肌组织 ,1例局部出现内膜间质的分化 ,1例部分区域间质水肿明显。 1例镜下见肿物一部分为透明细胞癌 ,另一部分呈APA改变 ,两者之间有过渡。随访 3个月～ 11年 ,除继发透明细胞癌的老年患者术后 16个月死亡外 ,其余均无复发。结论 :子宫非典型性息肉状腺肌瘤应注意与高分化宫内膜样癌、宫内膜息肉、腺肌瘤等鉴别。其临床经过良好 ,但非典型性显著者 。
Purpose To observe the clinicopathologic characteristics of the uterine atypical polypoid adenomyoma. Methods Six cases of uterine atypical polypoid adenomyoma, including one complicated with clear cell carcinoma, were retrieved and their HE slides were observed with light microscopy. Results The patients aged from 27 to 65 years old with the average of 43.1 years. Except that one was unknown with its location, two arose in the uterine fundus, two in low segment of uterine corpus, and one in uterine cervical canal. Histologically, they were composed of endometrial glands admixed with interlacing bundles of smooth muscle cells. The glands exhibited varying degrees of architectural and cytological atypia. The stromal component comprised mainly of smooth muscles with one case showing focal endometrial stromal differentiation. One patient had a clear cell carcinoma arising in the atypical polypoid adenomyoma. The follow up period ranged from 3 months to 11 years, and all but one with carcinoma were alive and well. Conclusion Atypical polypoid adenomyomas have benign clinical courses, but some cases may progress to endometrial carcinomas, especially in old patients with severe atypical epithelium.
出处
《临床与实验病理学杂志》
CAS
CSCD
2001年第4期275-278,共4页
Chinese Journal of Clinical and Experimental Pathology
