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为了探讨低级别子宫内膜间质肉瘤(LESS)的临床病理学特征、诊断和鉴别诊断,分析10例LESS的临床病理特点、网织纤维染色和免疫组化染色研究其病理学特征。结果显示,LESS临床上主要表现为阴道不规则流血;瘤细胞类似于增生期子宫内膜间质细胞,形态较一致,圆形或卵圆形,少数为短梭形,胞质较少,胞核圆形或不规则形,核染色质较细;肿瘤内有大量丛状生长的分支状小的、薄壁的血管,类似于子宫内膜的螺旋动脉,部分肿瘤血管透明变性呈星状或放射状结构;网织纤维染色见网状纤维丰富,围绕瘤细胞生长。肿瘤细胞8例CD10阳性,6例ER阳性,6例PR阳性,2例Actin阳性,CD34、CD117和Melan-A肿瘤细胞均阴性。初步研究结果提示,LESS易误诊为子宫内膜间质结节、未分化子宫内膜间质肉瘤、富于细胞性平滑肌瘤、静脉内平滑肌瘤病及血管周上皮样细胞肿瘤,确诊主要依靠组织病理学和免疫组织化学。
In order to investigate the clinicopathological features, diagnosis and differential diagnosis of low grade endometrial stromal sarcoma (LESS), the clinicopathological features of 10 cases of LESS were analyzed. The pathological features of the LESS were analyzed by using the reticulocyte staining and immunohistochemical staining. The results showed that the main clinical manifestations of LESS vaginal irregular blood flow; tumor cells similar to proliferative endometrial stromal cells, the shape is more consistent, round or oval, a few short fusiform, less cytoplasm, cells Nuclear round or irregular shape, nuclear chromatin thinner; tumor has a large number of plexiform growth of small branched, thin-walled blood vessels, similar to the endometrial spiral arteries, some of the tumor vascular degeneration was star-shaped or Radial structure; reticular fiber staining, see reticular fiber-rich, around the tumor cell growth. Tumor cells were CD10 positive, 6 ER positive, 6 PR positive, 2 Actin positive, and CD34, CD117 and Melan-A tumor cells were negative. Preliminary results suggest that LESS is often misdiagnosed as endometrial stromal nodules, undifferentiated endometrial stromal sarcoma, cell-rich leiomyoma, intravenous leiomyoma and perivascular epithelioid cell tumor, confirmed the main Rely on histopathology and immunohistochemistry.