摘要
目的：探讨女性生殖系统腺瘤样瘤的临床与大体病理特点及其鉴别诊断。方法：分析73例女性生殖系统腺瘤样瘤的临床表现及其大体形态等。结果：73例患者中，腺瘤样瘤发生于子宫者72例，其中子宫与卵巢冠同时发生者1例，另有发生于输卵管系膜1例。子宫腺瘤样瘤占同期子宫标本的2．4％，肿瘤多位于子宫浆膜下及近浆膜的子宫肌壁间，粘膜下少见。72例呈结节状，其中单发68例，多发4例，肿瘤直径1～5cm，余1例呈弥漫性生长。合并平滑肌瘤或腺肌病的比例为75％。临床表现无特征性，主要有月经紊乱21例，月经量增多17例，痛经27例，月经中期疼痛4例。大体检查可见特征性表现，肿瘤切面呈实性，灰白及灰黄色，质地较软，有网格与细小孔隙或小囊腔形成，小孔内有半透明稀粘液，肿瘤与周围肌层分界不清，无假包膜。镜下见肿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，伴平滑肌增生。免疫组织化学染色显示：56例肿瘤细胞间皮细胞抗体（Mc）和细胞角蛋白（cytokeratin，CK）均阳性。结论：女性生殖系统腺瘤样瘤为间皮起源，子宫为最常见的发生部位。子宫腺瘤样瘤的实际发病率远高于文献报道。临床及病理检查均易误诊和漏诊，应引起临床及病理医师的重视。免疫组化染色结果可作为诊断及鉴别诊断的重要拳孝依据。
Objective ：To investigate the clinical and pathological features of the female reproductive system adenomatoid tumors and to study the difference between the adenomatoid and the other diseases. Method： Chnical and macroscopic features in 73 cases with adenomatoid were observed. Results：There were 72 cases in uterus, 1 in fallopian tubes and 1 case in both the uterus and the ovary. The incidence of adenomatoid tumours in uterus was 2.4%, and nearly 75% of the cases were incorporated with leiomyomas or adenomyosis. 72 cases were in nodular pattern, and 1 in infused pattern. Grossly, the diameter of the 72 uterus tumors rang from 1 - 5cm. Most of them were located in the subserosa or near by the subserosa of the uterine and the rest located in the myometrium. The cut surface presented a nodular pattern with grayish white or yellowish in color, without a clear-cut margin from the surroundings. Microscopically, the tumor consisted of various gland-like structure or luminal spaces lined with flat, cuboidal or low columnar cells. Immunohistochemical staining showed the tumor cells positive for cytokeratin. Conclusion：Adenomatoid tumors of the female genital tract is mesothelial in origin and uterus is considered as the most common site of occurance. The adenomatoid must be included in the differentiated category of uterus nodule lesions. Immunohistochemical phenotypes can be used as an important evidence for differential diagnosis. The biological behavior of adenomatoid tumors is benign and with a good prognosis.
出处
《现代妇产科进展》
CSCD
北大核心
2008年第5期329-331,共3页
Progress in Obstetrics and Gynecology
关键词
腺瘤样瘤
子宫肿瘤
病理学
临床
诊断
鉴别
Adenomatoid
Uterine neoplasms
Pathology, clinical
Diagnosis
Diagnosis, differential
