Aida Y, Tadokoro M, Takeuchi E, Shinagawa T, Ishikawa E, Iwata M, Saito K
Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Acta Pathol Jpn. 1991 Oct;41(10):778-83. doi: 10.1111/j.1440-1827.1991.tb03351.x.
A rare case of myxoid variant of epithelioid leiomyosarcoma of the uterus in a 76-year-old woman is reported. Palpation and computed tomography revealed an enlarged uterus. Total hysterectomy and bilateral salpingo-oophorectomy were performed, and a hemispheric tumor, measuring 2.7 x 2.5 x 1.8 cm, was found protruding into the uterine cavity of the upper uterine segment. The tumor contained a prominent myxoid stroma and epithelioid tumor cells, which were round and polygonal in shape and showed positive immunoreactivity for desmin and vimentin. High mitotic activity was observed in the tumor cells. Electron microscopic examination revealed bundles of filaments in the cytoplasm and fine reticular material in the extracellular matrix. Histochemically, the myxoid stroma contained abundant acid mucopolysaccharide. The tumor cells were considered to originate from smooth muscle cells, while the myxoid stroma expressed varying differentiation of uterine mesenchymal cells. The patient is currently well with no evidence of recurrence or metastasis one year after the operation.
报告了一例76岁女性子宫上皮样平滑肌肉瘤黏液样变型的罕见病例。触诊和计算机断层扫描显示子宫增大。进行了全子宫切除术和双侧输卵管卵巢切除术，发现一个半球形肿瘤，大小为2.7×2.5×1.8 cm，突入子宫上段的宫腔。肿瘤含有显著的黏液样间质和上皮样肿瘤细胞，细胞呈圆形和多边形，结蛋白和波形蛋白免疫反应呈阳性。肿瘤细胞中观察到高有丝分裂活性。电子显微镜检查显示细胞质中有成束的细丝，细胞外基质中有精细的网状物质。组织化学检查显示，黏液样间质含有丰富的酸性黏多糖。肿瘤细胞被认为起源于平滑肌细胞，而黏液样间质表现出子宫间充质细胞的不同分化。患者术后一年情况良好，无复发或转移迹象。
