Nemoto T, Shinoda M, Komatsuzaki K, Hara T, Kojima M, Ogihara T
Department of Obstetrics and Gynecology, Haga Red Cross Hospital, Moka, Japan.
Pathol Int. 1994 Jun;44(6):454-9. doi: 10.1111/j.1440-1827.1994.tb01710.x.
A case of vulvar leiomyoma with extensive myxoid change in a 40 year old female is described. The tumor had a unique connection with a non-degenerative leiomyoma that compressed the rectum and the bladder. Scattered smooth muscle cells in a loose myxoid stroma were immunoreactive for desmin. Fibroblast-like spindle cells were immunoreactive for vimentin but not for desmin. The initial, although incorrect, pathological diagnosis of the tumor was aggressive angiomyxoma based on the similarity in both clinical and pathological aspects with this more invasive tumor. Myxoid vulvar leiomyoma should also be differentiated from angiomyofibroblastoma. The key to the differential diagnosis is the presence of interlacing smooth muscle cells and an awareness of tendency toward myxoid change in vulvar leiomyomas.
本文描述了一例40岁女性的外阴平滑肌瘤，伴有广泛的黏液样变。该肿瘤与一个未退变的平滑肌瘤有独特的关联，后者压迫直肠和膀胱。散在于疏松黏液样间质中的平滑肌细胞结蛋白免疫反应阳性。成纤维细胞样梭形细胞波形蛋白免疫反应阳性，但结蛋白免疫反应阴性。基于该肿瘤在临床和病理方面与这种更具侵袭性的肿瘤相似性，最初的病理诊断为侵袭性血管黏液瘤，尽管这是错误的。黏液样外阴平滑肌瘤也应与血管肌纤维母细胞瘤相鉴别。鉴别诊断的关键在于是否存在交织的平滑肌细胞以及对外阴平滑肌瘤黏液样变倾向的认识。
