摘要
目的探讨子宫静脉内平滑肌瘤病（IVL）的临床生物学行为、病理学特点及其免疫表型的临床意义。方法应用免疫组化方法检测子宫IVL肿瘤细胞vimentin、desmin、SMA、CD10、CD34、ER和PR的表达情况。结果6例患者术前均诊断为子宫多发性平滑肌瘤,未曾怀疑为IVL 3例行全子宫切除术,3例行全子宫及双侧附件切除术,其中1例术中见灰白色条索样肿物蔓延致右侧宫角和宫旁组织静脉内 病理检查发现6例标本除合并血管外子宫平滑肌瘤外,子宫肌壁间大小不一的静脉内见平滑肌细胞构成的瘤栓。6例患者经随访6～51个月未见复发。免疫组化染色显示,IVL瘤细胞vimentin、desmin和SMA（＋）,CD10和CD34（-） 其中5例肿瘤细胞ER和PR呈强（＋）,1例呈（＋）。结论IVL是组织学表现为良性却具有类似恶性肿瘤生长方式的一类罕见肿瘤,有远期复发的倾向。IVL肿瘤细胞存在雌、孕激素高表达特性,提示卵巢去势治疗或术前、术后应用雌激素拮抗剂可能是有效的辅助治疗手段。
Objective To study the clinical and pathological characteristics of intravenous leiomyomatosis （IVL） of the uterus and its immunohistochemical phenotype. Methods 6 cases of IVL diagnosed by pathologic examination were reviewed and analysed. Meanwhile, staining of vimentin, desmin, SMA, CD10, CD34, ER and PR were performed Results Utemus leiomyoma was diagnosed in all 6 cases and no IVL was suspected preoperatively. A total hysterectomy was performed in 3 patients and a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed in other 3 patients. In 1 specimen, tumor extended along venous lumina to right corneal and parametrial vessels. Histologic examination revealed the features of IVL in all 6 cases. Immunohistochemically, the intravenous part of IVL revealed a positive expression of vimentin, desmin, SMA and negative expression of CD10 and CD34. Estrogen and progesterone receptors were strongly and positively expressed in 5 IVL tissues. Conclusions IVL of the uterus is a rare neoplasm characterised by nodular masses of histologically benign smooth muscle growing within veins but with a malignant behaviour. Strongly positive expression of ER/PR in IVL tissues snggests that removal of ovarian function and use of antiextrogen drugs before and after total surgical excision of tumor may be effective.
出处
《诊断病理学杂志》
CSCD
2009年第3期198-200,203,共4页
Chinese Journal of Diagnostic Pathology
关键词
子宫肿瘤
静脉内平滑肌瘤病
免疫组化
Uterine tumor
Intravenous Leiomyomatosis
Immunohistochemical analysis
