Clement P B, Young R H
Department of Pathology, Vancouver General Hospital, British Columbia, Canada.
Int J Gynecol Pathol. 1987;6(4):322-30. doi: 10.1097/00004347-198712000-00004.
The clinical and pathological features of four cases of diffuse leiomyomatosis of the uterus are described. The patients, whose ages ranged from 22 to 38 years, all had an enlarged uterus on pelvic examination and underwent hysterectomy. On gross examination, the uterus was typically symmetrically enlarged due to almost complete replacement of the myometrium by innumerable, poorly defined, confluent nodules. Microscopic examination revealed that the nodules were composed of benign cellular smooth muscle. In each case there was a focal proliferation of perivascular smooth muscle cells within the nodules, and in one case, the normal myometrium. Distinction from intravenous leiomyomatosis and low-grade endometrial stromal sarcoma, one or both of which were initially considered in the differential diagnosis in three of the cases, is important.
本文描述了4例子宫弥漫性平滑肌瘤病的临床和病理特征。患者年龄在22岁至38岁之间，盆腔检查均发现子宫增大，并接受了子宫切除术。大体检查显示，子宫通常对称增大，这是由于无数边界不清、相互融合的结节几乎完全取代了肌层。显微镜检查显示，这些结节由良性的细胞性平滑肌组成。在每例病例中，结节内均有血管周围平滑肌细胞的局灶性增生，其中1例病例中，正常肌层也有这种增生。与静脉内平滑肌瘤病和低级别子宫内膜间质肉瘤相鉴别很重要，在3例病例的鉴别诊断中最初均考虑了其中一种或两种疾病。
