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1、子宫外子宫内膜间质肉瘤1例病理分析及文献复习【关键词】子宫内膜间质肉瘤AcasereportofextrauterinelowgradeendometrialstromalsarcomaandreviewofliteraturesHUIYanPing,GUOShuangPing,WANGYingMei,CHENWanLuDepartmentofPathology,XijingHospital,FourthMilitaryMedicalUniversity,Xi’an710033,China【Ab
2、stract】AIM:Toreportacaseofprimaryextrauterineendometrialstromalsarcoma(ESS)anddiscussthemorphologicandimmunohistochemicalfeatureswithareviewofrecentliteratures.METHODS:Theclinicalcharacteristics,histologicalfeaturesandimmunologicalpropertiesofESSwere
3、analyzedretrospectivelyusingroutineHEstaining,transmissionelectronmicroscopic(TEM)andimmunohistochemicalmethods.RESULTS:ThereportedcaseofprimaryextrauterineESSinthisarticlepresentedlesionsinmultipleorgansandmultiplefoci,involvingrightovary,appendix,c
4、olonandgreateromentum.Islandsofendometrialtissuewithwellformedglandsandstromawerefoundinthecase.Histologically,theprimaryextrauterineESSwascharacterizedbyaninfiltrativeanddiffuseproliferationofuniformroundorovalcells,abundantsmallvessels,lowmitoticac
5、tivity,thepresenceoffoamcellsandvascularinvasion.TEMrevealedthatthetumorcellsresemblednormalproliferativephaseendometrialstromalcellsandtheyshowedvariabledegreesofsmoothmuscledifferentiationandfibroblastdifferentiation.Immunohistochemically,thetumorc
6、ellswerediffuselystainedforvimentin,desmin,EMA,estrogenreceptor(ER)andprogesteronereceptor(PR),butnotstainedforCK，SMA,S100,LCAandCD34.CONCLUSION:TheseresultsindicatethatprimaryextrauterineESSoriginatesfromendometrialstromalcells,whichmayderivefromthe
7、Mulleriansystem.ThecasedemonstratesthatextrauterineESSmaystemfromapreexistingendometriosisandmayhaveapotentialforsmoothmuscle,fibroblastandepithelialdifferentiation.PRandERareidentifiedaspositiveinthecase,whichindicateshormonalsensitivity.【Keywords】e
8、ndometrialstromalsarcoma;mulleriantumor;endometriosis;immunohistochemistry;ultrastructure【摘要】目的：探讨子宫外子宫内膜间质肉瘤(endometrialstromalsarcoma,ESS)的组织形态学及免疫组织化学特点.方法：应用光镜、透射电镜和免疫组织化学标记对1例子宫外原发性ESS进行观察并文献复习.结果：本例子宫外原发性ESS病变为多发性，累及右卵巢、阑尾、结肠和大网膜等处，伴有右卵巢、阴道、阑尾、
