摘要
目的:探讨子宫非典型息肉样腺肌瘤(APA)临床病理学特点及鉴别诊断。方法:收集和观察5例子宫非典型息肉样腺肌瘤的临床病理特点并复习文献。结果:5例患者年龄27~51岁,平均年龄37.2岁,临床表现均为阴道不规则流血,经量增多,2例为多囊卵巢综合征,1例原发不孕,5例中有1例误诊为高分化子宫内膜样腺癌。组织学特点:复杂分支腺管状结构,腺体不同程度增生,腺上皮伴异型,其中4例伴鳞状化生,腺体周围间质由多少不等的平滑肌和纤维组织构成。治疗:其中4例行息肉及内膜切除并药物治疗,1例行全子宫切除术。5例术后随访6月~3年均无瘤健在。结论:APA临床经过良好,病理形态学需要与高分化子宫内膜样腺癌鉴别,肿瘤存在低度恶变潜能,少数可合并或发展成子宫内膜样腺癌,临床应根据年龄及有无生育要求制定治疗方案,治疗后需密切随访。
Objective To explore the clinical features and differential diagnosis of atypical polypoid adenomyoma(APA).Methods The clinicopathologic features of 5 cases of atypical polypoid adenomyoma of uterus were collected and observed.Results 5 patients age 27-51, the average age of 37.2 years, clinical manifestations are irregular vaginal bleeding, the volume increase, 2 cases of polycystic ovary syndrome, 1 case of primary infertility, 5 cases with 1 case was misdiagnosed as welldifferentiated endometrial adenocarcinoma. Histologic features: complex branch structure of the gland, a gland hyperplasia of different level, glandular epithelium with special shape, among them 4 cases with squamous metaplasia, glands surrounding stroma made up of varying amounts of smooth muscle and fibrous tissue. Treatment 4 routine polyps and endometrial excision and medication, 1 routine hysterectomy. 5 cases were followed up from 6 months to 3 years. Conclusion Clinical after good, APA pathomorphism needs and well-differentiated endometrial adenocarcinoma identification, tumor is low malignant potential, a few can be merged or develop endometrial adenocarcinoma, clinical should according to age and fertility for treatment or not, should be closely followed up after treatment.
作者
亢姝娇
崔丽燕
刘小宁
张立君
Kang Shujiao;Cui Liyan;Liu Xiaoning;Zhang Lijun(Department of Pathology,Maternal and Child Health Institute of Inner Mongolia Autonomous Region,Hohhot Inner Mongolia 010020,China)
出处
《影像研究与医学应用》
2018年第20期17-19,共3页
Journal of Imaging Research and Medical Applications
关键词
子宫非典型息肉样腺肌瘤
临床病理
诊断
Uterine atypical polypoid adenomyoma
Clinical pathological
Diagnosis
