Reynaud P, Le Bouëdec G, Déchelotte P, Dauplat J, Chassagne J, Fonck Y
Centre Jean-Perrin, F 63011 Clermont-Ferrand.
J Gynecol Obstet Biol Reprod (Paris). 1995;24(1):30-4.
Three rare cases of tumours of the cervix are reported: embryonal rhabdomyosarcoma, granulocyte sarcoma and lymphoma. There were particular problems with diagnosis in each case requiring histochemistry, immunohistochemistry and ultrastructure examinations. Embryonal rhabdomyosarcoma is a uncommon tumour in the adult. Clinically, there is a vegetative formation but no botryoid aspect. Striated muscle cell proliferation, suggested by the morphology of the malignant cells was confirmed by immunohistochemistry which demonstrated desmine and vimentine and by the ultrastructural study which demonstrated Z lines in the cytoplasm of the malignant cells. Granulocyte sarcoma is characterized by a non-tumoural non-destructive infiltration of inflammatory-like cells. Their granulocyte nature is confirmed by histochemistry, the Leder's reaction on frozen samples, immunohistochemistry (expression of NP57). Electron microscopy can also be used. The diagnosis of lymphoma is difficult due to the non-tumoural nature of the lymphomatous infiltration which can simulate inflammatory reaction. In our case, the diagnosis was made on the tumoural aspect of the biopsy made in the deep infiltration zone of an adjacent organ (bladder). Immunohistochemistry demonstrated the lymphoid nature of the tumour and identified a B phenotype. The ultrastructural study gave little information.
报告了3例罕见的子宫颈肿瘤:胚胎性横纹肌肉瘤、粒细胞肉瘤和淋巴瘤。每例病例在诊断方面都存在特殊问题,需要进行组织化学、免疫组织化学和超微结构检查。胚胎性横纹肌肉瘤在成年人中是一种罕见肿瘤。临床上,有赘生物形成,但无葡萄状外观。恶性细胞形态提示的横纹肌细胞增殖通过免疫组织化学得以证实,免疫组织化学显示结蛋白和波形蛋白阳性,超微结构研究显示恶性细胞胞质中有Z线。粒细胞肉瘤的特征是炎症样细胞的非肿瘤性、非破坏性浸润。通过组织化学、冷冻样本的Leder反应、免疫组织化学(NP57表达)证实了它们的粒细胞性质。电子显微镜检查也可使用。淋巴瘤的诊断困难,因为淋巴瘤浸润的非肿瘤性质可模拟炎症反应。在我们的病例中,诊断是基于在相邻器官(膀胱)深层浸润区所取活检的肿瘤表现做出的。免疫组织化学显示了肿瘤的淋巴样性质并确定为B表型。超微结构研究提供的信息很少。