摘要
目的探讨子宫炎性肌纤维母细胞瘤(IMT)的临床病理特征、免疫表型、分子遗传学特征、鉴别诊断及治疗方法。方法回顾性分析郑州大学第一附属医院3例子宫IMT的临床病理学特征,并复习相关文献。结果患者发病年龄30~60岁。肿瘤均位于子宫体黏膜下,质地中等或稍软、有黏液感。其中2例组织形态学以黏液型为主,黏液样变的基质中见梭形细胞稀疏排列,区域密集的梭形细胞呈束状,类似平滑肌瘤,间质炎细胞浸润,局灶肿瘤细胞轻度异型,核分裂相少见。另外1例伴有妊娠,组织形态学以富于细胞型为主,具有提示侵袭性生物学的特点:浸润性生长、核分裂相多见、血管内生长。局灶可见蜕膜样变的肿瘤细胞。免疫组化显示3例肿瘤均不同程度表达间变性淋巴瘤激酶(ALK),荧光原位杂交检测证实2例肿瘤存在ALK基因重排,患者术后随访均未见转移和复发。结论子宫IMT的临床病理特征与平滑肌肿瘤、子宫内膜间质肿瘤有重叠,建议诊断时应结合病理组织学特征及免疫组化标记,必要时进行基因检测。
Objective To discuss the clinicopathological features,immunophenotypes,molecular genetics,differential diagnosis and treatment of uterine inflammatory myofibroblastic tumor(IMT).Methods The clinicopathological features of 3 cases of uterine IMT in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed,and reviewed in combination with the related literature.Results The age of the three patients ranged 30 to 60 years.All tumors were intramural in location,with a medium or slightly soft texture and a mucus sensation.Histologically,two cases were mainly myxoid pattern,with myxoid stroma sparsely arranged in fascicles of spindle cells,similar to leiomyomas.Atypia of tumor cells were mild,with infiltration of inflammatory cell.The other case was associated with pregnancy.Histocytosis was a predominantly cellular type with features suggestive of invasive biology:invasive growth,frequent mitoses,and intravascular growth.In addition,decidual-like neoplastic cells were seen focally.All the three tumors were ALK-positive with granular cytoplasmic staining by immunohistochemistry.ALK gene rearrangements were detected by fluorescence in situ hybridization in two tumors.No metastasis or recurrence was found during the postoperative follow-up.Conclusion The clinical and pathological features of uterine IMT overlap with smooth muscle tumors and endometrial stromal tumors.The diagnosis should be based on histological features and ALK immunohistochemistry,and genetic testing should be performed when necessary.
作者
张哲
孙淼淼
许跃
罗婷
于丽莹
余兰燕
陈奎生
ZHANG Zhe;SUN Miaomiao;XU Yue;LUO Ting;YU Liying;YU Lanyan;CHEN Kuisheng(Department of Pathology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《肿瘤基础与临床》
2024年第1期37-41,共5页
journal of basic and clinical oncology
基金
河南省中青年卫生健康科技创新领军人才项目(YXKC2022015)。
