子宫腺瘤样瘤的病理及临床分析

摘要

目的 探讨子宫腺瘤样瘤的临床特点、鉴别诊断及治疗方案.方法 对我院2008年6月至2010年12月,经病理检查确诊为子宫腺瘤样瘤的68例进行病理及临床分析.结果 子宫腺瘤样瘤合并平滑肌瘤35例,子宫腺瘤样瘤合并子宫腺肌病11例,子宫腺瘤样瘤合并平滑肌瘤及子宫腺肌病8例,单纯子宫腺瘤样瘤14例.肿瘤多位于近子宫角和宫体或宫底浆膜下,其次为子宫肌壁间,内膜下少见.肿瘤直径0.8 ～4.5 cm,临床表现无特征性.瘤细胞组成形态不一的腺样及腔隙样结构,腔隙内衬以扁平或立方上皮细胞,大多数表现为脉管样形态.结论 子宫腺瘤样瘤并非罕见,多与子宫平滑肌瘤及子宫腺肌症并存,临床和病理上均易误诊和漏诊,对标本进行全面彻底的检查,对切面黏滑,有细小孔隙样结构,无假包膜特征性部位多取材,结合免疫组织化学法,能提高其检出率.手术切除是治疗的首选方法,预后良好,未见复发转移.%Objective To study the clinical-pathological characteristics,differential diagnosis and treatment options of uterine adenomatoid tumor.Methods From June 2008 to December 2010,68 cases diagnosed of uterine adenomatoid tumor were analyzed.Results Among them,35 cases had leiomyoma with uterine adenomatoid tumor,13 cases had uterine muscle adenosis,8 cases had leiomyoma and adenomyosis.Most tumors were located in the places which was close to the cornua uter,corpus uter or subserous layers.Tumor diameter distribution was from 0.8 cm to 4.5 cm and there were no clinical manifestations.Uterine adenomatoid tumor was composed of small glandlike spaces lined with flattened or cuboidal mesothelium-like cells.Conclusions Uterine adenomatoid tumor is not uncommon and often coexists with uterine leiomyoma and adenomyosis.Misdiagnosis and missed diagnosis in clinical and pathological often happen.Operation excision is the preferred method of treatment.