子宫纤维瘤病1例临床病理分析及文献复习

摘要

Objective: To observe the clinicopathological features, immunohistochemical type and differential diagnosis of uterine fibromatosis. Methods: One case of uterine fibromatosis was studied with histopathology, immunohistochemistry examination and the related literatures were reviewed. Results: Grossly, the mass was nodulated and indistinct margin, with a white-grey cut surface. Microscopy revealed that the neoplasm was composed of spindle cells and collagen fibers, arrayed bunchy and striation, extended to the surrounding tissue. Immunohistochemical findings showed that the tumor cells were positive for vimentin, partly positive for SMA, but negative for Desmin, H-caldesnen and Calponin. Conclusions: The diagnosis of uterine fibromatosis mainly relies on pathological examination. Morphologically, it should be differentiated from other spindle cell lesions in the uterus, such as hysteromyoma, adenomyosis,fibrosarcoma,perivascular epithelioid cell tumor,leiomyosarcoma and endometrial stromal sarcoma.%目的 探讨子宫纤维瘤病的临床病理学特点、免疫表型和鉴别诊断.方法 对1例子宫纤维瘤病进行组织学和免疫组织化学观察,并复习文献.结果 巨检肿瘤呈结节状,边界欠清,切面灰白色,质嫩.镜检肿瘤由梭形细胞和胶原纤维组成,呈束状、条带状交错排列,向周围组织浸润.瘤细胞Vimentin阳性,SMA多数细胞阳性,Desmin、H-caldesmen和Calponin细胞均阴性.结论 子宫纤维瘤病主要依靠组织病理学诊断,形态上应注意与平滑肌瘤、腺肌瘤、纤维肉瘤、血管周上皮样细胞肿瘤、平滑肌肉瘤、子宫内膜间质肉瘤等病变进行鉴别.