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肝外子宫腺肌瘤伴局灶性细胞平滑肌成分,发生于子宫肌瘤切除术病史患者:病例报告及文献复习。

Extrauterine adenomyoma of the liver with a focally cellular smooth muscle component occurring in a patient with a history of myomectomy: case report and review of the literature.

出版信息

Diagn Pathol. 2013 Aug 5;8:131. doi: 10.1186/1746-1596-8-131.

Abstract

UNLABELLED

Since first reported in 1986, 14 cases of extrauterine adenomyoma have been reported in the English literature, most often occurring in the ovaries. In this report, we present the first case of extrauterine adenomyoma involving the liver in a 29-year-old woman who presented with a 2-year history of low back pain with recent worsening and a history of laparoscopic myomectomy 5 years previously. Gross inspection of the specimen revealed a subcapsular mass that had a well-circumscribed margin with the adjacent liver tissue. By histopathologic examination, the multilobular mass was composed of a smooth muscle component and benign endometrioid glands and stroma. The smooth muscle component was focally cellular, and the endometrioid glands had secretory features. Both the smooth muscle component and endometrioid tissue were positive for ER and PR. The smooth muscle component was also positive for desmin and SMA, while the endometrioid stroma was positive for CD10. Other extrauterine lesions composed of a mixture of smooth muscle tissue and heterotopic endometrioid tissue, including endometriosis with a smooth muscle component, leiomyomatosis/leiomyomas associated with endometriosis and uterus-like masses, should be included in differential diagnoses. The patient was free from recurrence 5 months after liver tumor resection.

VIRTUAL SLIDES

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1327125766102291.

摘要

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自 1986 年首次报道以来,英文文献中已报道了 14 例子宫外腺肌瘤病例,这些病例大多发生在卵巢。在本报告中,我们报告了首例涉及肝脏的子宫外腺肌瘤病例,患者为 29 岁女性,有 2 年的腰痛病史,最近病情加重,且 5 年前曾行腹腔镜子宫肌瘤切除术。标本大体检查显示肝脏被摸下有一界限清楚的肿块。组织病理学检查显示,多叶肿块由平滑肌成分和良性子宫内膜样腺体和基质组成。平滑肌成分局灶性细胞丰富,子宫内膜样腺体具有分泌特征。ER 和 PR 均阳性表达于平滑肌成分和子宫内膜样组织。平滑肌成分还阳性表达于 desmin 和 SMA,而子宫内膜样基质阳性表达于 CD10。其他由平滑肌组织和异位子宫内膜样组织混合组成的子宫外病变,包括伴平滑肌成分的子宫内膜异位症、与子宫内膜异位症相关的平滑肌瘤病/平滑肌瘤和子宫样肿块,应包括在鉴别诊断中。患者在肝肿瘤切除术后 5 个月无复发。

虚拟幻灯片

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b6a/3771407/22fe4066426b/1746-1596-8-131-1.jpg

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