Myxoid and fibrous endometrial stromal tumors of the uterus: A report of 10 cases
Myxoid and fibrous endometrial stromal tumors of the uterus: A report of 10 cases
复制标题
DOI：
10.1097/00004347-199910000-00004
复制
发表时间：
1999-10-01
影响因子：
2.4
通讯作者：
Scully, RE
中科院分区：
文献类型：
--
作者：
Oliva, E;Young, RH;Scully, RE
本文报告了10例子宫内膜间质肿瘤，表现为明显的粘液样或纤维样，或两者兼有，导致诊断困难。患者年龄32 ~ 52岁，平均39岁。3例出现功能失调性子宫出血，1例出现腹痛。5例患者触诊子宫增大或盆腔肿块; 1例患者产后偶然发现肿瘤。所有患者均行子宫切除术。肿瘤最大径4 ~ 20 cm。六是软。息肉样腔内肿块，4例主要位于子宫肌层内：2例为凝胶状。在显微镜检查中，9个肿瘤浸润子宫肌层（间质肉瘤），1个肿瘤边界清楚（间质结节），6个肿瘤主要由纤维成分组成，肿瘤细胞被不同量的胶原蛋白隔开：3个肿瘤中存在广泛的玻璃样变性区域。两个肿瘤主要由细胞减少的区域和丰富的粘液样基质组成，两个肿瘤的两种成分的比例大致相等。透明质酸酶预消化可消除阿辛蓝染色。在粘液区。4例肿瘤均具有典型的子宫内膜间质瘤样病变的形态学特征。所有这些都包含许多小的薄壁血管。波形蛋白和平滑肌肌动蛋白分别在9个肿瘤中的9个和9个肿瘤中的7个中呈阳性，而结蛋白在9个肿瘤中的6个中呈阴性，在其他3个中仅局部阳性。一名患者在初次诊断时有网膜结节，另一名患者在子宫切除术后2年盆腔复发。其他病例的随访信息不可用或很短。鉴于大多数肿瘤的典型位置、生长方式、特征性小动脉的含量，应考虑其为子宫内膜间质起源。在某些情况下，原发性或复发性肿瘤中存在典型的子宫内膜间质瘤变，并且没有证据表明起源于子宫内膜间质以外的细胞类型。这些谣言可能是相同的，至少在某些情况下，在旧的文献中称为“粘液纤维肉瘤”的肿瘤。"
Ten endometrial stromal tumors of the uterus with a prominent myxoid or fibrous appearance, or both, that led to problems in interpretation are reported. The patients were 32 to 52 (mean 39) years of age. Three presented with dysfunctional uterine bleeding and one with abdominal pain. An enlarged uterus or a pelvic mass was palpated in five patients; the tumor was an incidental postpartum finding in one patient. All patients underwent hysterectomy. The tumors ranged from 4 to 20 cm in greatest dimension. Six were soft. polypoid intracavitary masses and four were predominantly intramyometrial: two were gelatinous. On microscopic examination, nine tumors infiltrated the myometrium (stromal sarcomas) and one was well circumscribed (stromal nodule), Six tumors had a predominantly fibrous component with the neoplastic cells separated by variable amounts of collagen: extensive areas of hyalinization were present in three tumors. Two tumors were predominantly composed of hypocellular areas with an abundant myxoid matrix, and two had both components in roughly equal proportions. Alcian blue staining was positive, with the staining eliminated by hyaluronidase predigestion. in the myxoid areas. The typical morphologic features of endometrial stromal neoplasia were present focally in four tumors. All of them contained numerous small thin-walled vessels. Vimentin and smooth muscle actin were positive in nine of nine and seven of nine tumors, respectively, whereas desmin was negative in six of nine tumors and only focally positive in the other three. One patient had omental nodules at the time of the initial diagnosis and another had a pelvic recurrence 2 years after hysterectomy. Follow-up information is unavailable or short in the other cases. These tumors should be considered of endometrial stromal origin in view of the typical location of most of them, their growth pattern, content of characteristic arterioles. presence of typical endometrial stromal neoplasia in the primary or recurrent tumor in some cases, and absence of evidence of origin from a cell type other than endometrial stroma. These rumors may be identical, in some instances at least, to tumors referred to in the older literature as "myxofibrosarcomas."