Atypical polypoid adenomyoma of the uterus: A reappraisal of the clinicopathological and immunohistochemical features
Atypical polypoid adenomyoma of the uterus: A reappraisal of the clinicopathological and immunohistochemical features
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DOI：
10.1016/j.prp.2019.01.016
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发表时间：
2019-04-01
影响因子：
2.8
通讯作者：
Chen, Qin
中科院分区：
文献类型：
--
作者：
Lu, Bingjian;Yu, Minghua;Chen, Qin
非典型息肉样腺肌瘤是一种罕见的子宫上皮间质混合性肿瘤。与子宫内膜癌的区别仍有待澄清。在这项研究中，我们比较了36例APAM和48例子宫内膜癌的病理学和免疫组化特征。13例APAM结构复杂，与5例子宫内膜不典型增生和1例子宫内膜癌并存。2例患者在1个月和102个月时患有子宫内膜癌。4例患者在1-57个月时复发，但无一例死于疾病。纤维肌性间质表现出3个不典型的特征：宽束（10/36），由间质分支分隔的小叶结构（26/36）和纤维肌性间质在表面上皮下的延伸（31/36）。而子宫内膜癌除了呈模糊的分叶型外，未见这些特征。APAM和子宫内膜癌均表现出相似的免疫染色模式，但子宫内膜癌的Ki 67指数较高（p < 0.05）。我们的研究表明，纤维肌性间质的独特特征有助于APAM和子宫内膜癌的鉴别诊断。
Atypical polypoid adenomyoma (APAM) is an uncommon uterine mixed epithelial and mesenchymal tumor. The discrimination from endometrial carcinoma remains to be clarified. In this study, we compared the dinicopathological and immunohistochemical features between 36 APAMs and 48 endometrial carcinomas. APAM with a highly complex structure (n = 13) coexisted with atypical hyperplasia (n = 5) and endometrial carcinoma (n = 1). Two patients had endometrial carcinomas at 1 and 102 months. Four patients recurred at 1-57 months but none died of disease. The fibromuscular stroma demonstrated 3 uncharacterized features: a broad bundle (10/36), a lobular structure separated by the stromal branches (26/36), and the extension of fibromuscular stroma underneath the surface epithelium (31/36). However, these features were not seen in endometrial carcinomas except the vaguely lobular pattern. Both APAM and endometrial carcinoma showed a similar immunostaining pattern except high Ki67 index in endometrial carcinomas (p < 0.05). Our study suggests that the distinct features of the fibromuscular stroma can aid in the differential diagnosis between APAM and endometrial carcinoma.