Gupta Nalini, Awasthi Anshu, Rajwanshi Arvind, Sarla Malhotra
Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Acta Cytol. 2007 May-Jun;51(3):461-3. doi: 10.1159/000325768.
Endometrial stromal sarcoma (ESS) is a rare neoplasm and is composed of E cells closely resembling normal proliferative endometrial stromal cells. Because of its rarity, the preoperative diagnosis is difficult for clinicians. These tumors are rarely subjected to fine needle aspiration (FNA), and the cytologic diagnosis is also difficult, as the differential diagnosis is leiomyosarcoma/cellular leiomyoma.
A 23-year-old woman presented with a history of prolonged vaginal bleeding. The diagnosis on FNA was given as sarcoma with the possibility of low grade ESS or leiomyosarcoma. On histopathologic examination, the diagnosis was confirmed to be low grade ESS.
Aspirates of low grade ESS are extremely cellular, with cohesive tissue fragments of monotonous, small, oval cells with bland chromatin tightly women in a metachromatic, extracellular matrix. The differential diagnosis should include a cellular leiomyoma and leiomyosarcoma.
子宫内膜间质肉瘤（ESS）是一种罕见的肿瘤，由与正常增殖期子宫内膜间质细胞极为相似的细胞组成。由于其罕见性，临床医生术前诊断困难。这些肿瘤很少接受细针穿刺抽吸（FNA），且细胞诊断也很困难，因为鉴别诊断为平滑肌肉瘤/细胞性平滑肌瘤。
一名23岁女性有长期阴道出血史。FNA诊断为肉瘤，可能为低级别ESS或平滑肌肉瘤。经组织病理学检查，确诊为低级别ESS。
低级别ESS的穿刺物细胞极其丰富，有呈团状的组织碎片，由形态单一、小而椭圆形的细胞组成，染色质淡，紧密排列于异染性细胞外基质中。鉴别诊断应包括细胞性平滑肌瘤和平滑肌肉瘤。
