Rollason T P, Redman C W
Department of Pathology, Medical School, University of Birmingham, Edgbaston, England.
Eur J Gynaecol Oncol. 1988;9(6):444-51.
The clinico-pathological features of four examples of a distinctive benign uterine neoplasm are presented which has previously been titled atypical adenomyoma. The patients were all nulliparous and premenopausal. All presented with menstrual disturbances. No tumour has recurred after hysterectomy (follow-up between 10 years and 10 months). All tumours arose from the corpus, three were localised lower segment polyps, one a diffuse polypoid involvement of the endometrium. Histologically all of the tumours showed very similar appearances with closely packed, regular, tubular glands lined by low columnar epithelium, resembling most closely basal endometrial glands and surrounded by benign connective tissue which by simple tinctorial methods appeared to be largely smooth muscle. No heterologous components were seen. In two cases squamous metaplasia was extensive, in one microcalcification was present. The histological appearances favour a type of benign mixed Mullerian tumour but the appearances are not typical of Mullerian adenofibroma. Immunocytochemistry performed on 3 cases confirmed that the stroma was in large part smooth muscle, though much of the stroma stained only weakly with monoclonal antidesmin antibody.
本文介绍了一种独特的良性子宫肿瘤4例的临床病理特征，该肿瘤之前被命名为非典型腺肌病。患者均未生育且处于绝经前。所有患者均有月经紊乱症状。子宫切除术后所有肿瘤均未复发（随访时间为10年零10个月）。所有肿瘤均起源于子宫体，3例为下段局限性息肉，1例为子宫内膜弥漫性息肉样受累。组织学上，所有肿瘤表现非常相似，有紧密排列、规则的管状腺体，内衬低柱状上皮，与最接近的基底子宫内膜腺体相似，并被良性结缔组织包围，通过简单染色方法，该结缔组织在很大程度上似乎是平滑肌。未见异源性成分。2例鳞状化生广泛，1例有微钙化。组织学表现支持一种良性混合性苗勒管肿瘤，但表现并非苗勒管腺纤维瘤的典型表现。对3例进行的免疫细胞化学检查证实，间质大部分为平滑肌，尽管大部分间质仅用单克隆抗结蛋白抗体染色较弱。
