Service of Pathology, Torrecárdenas Hospital, Almería, Spain.
Arch Gynecol Obstet. 2010 Oct;282(4):451-4. doi: 10.1007/s00404-010-1383-7. Epub 2010 Feb 16.
The morphologic and immunohistochemical findings of a well-circumscribed leiomyoadenomatoid tumor located in the posterior uterine wall are reported.
The patient was a 55-year-old white woman who complained of peri/postmenopausal and irregular bleeding during the past 4 months. The adenomatoid component was intermingled with bland smooth muscle fascicles and was composed of vacuolated cells, tubules, and slit-like structures crossed by epithelial bridges. Immunohistochemistry revealed positivity to epithelial and mesothelial markers in the adenomatoid component and strong immunoreaction for smooth muscle markers in the leiomyomatous one.
The well-defined circumscription and the presence of mesothelial component intermingled with the leiomyomatous proliferation favors the hypothesis that a leiomyo-adenomatoid tumor should be considered as a subtype of adenomatoid tumor with distinctive morphological features. Only four previous cases of this rare neoplasm have been reported to date, one in the epydidimis and the other three cases in the uterine wall, one of them affecting also to the right ovary.
本文报道了一例发生在后子宫壁的边界清楚的平滑肌腺肌瘤样肿瘤的形态学和免疫组织化学表现。
患者为 55 岁白人女性，诉绝经后 4 个月出现围绝经期及不规则阴道出血。腺管样成分与平滑肌束混合存在，由空泡状细胞、小管和横过上皮桥的裂隙样结构组成。免疫组织化学显示腺管样成分上皮和间皮标志物阳性，平滑肌标志物在平滑肌肿瘤中强烈反应。
明确的边界和间皮成分与平滑肌瘤增生混合存在，支持这样一种假说，即平滑肌腺肌瘤样肿瘤应被视为腺肌瘤样肿瘤的一个亚型，具有独特的形态特征。迄今为止，仅报道了 4 例这种罕见肿瘤，1 例发生在附睾，3 例发生在子宫壁，其中 1 例还累及右侧卵巢。
