Shi Y F, Xie X, Zhao C L
Women's Hospital, Zhejiang Medical University, Hangzhou.
Zhonghua Fu Chan Ke Za Zhi. 1994 Apr;29(4):201-4, 251.
Between leiomyoma and leiomyosarcoma there exists a series of borderline smooth muscle tumors of the uterus, including cellular, bizarre, mitotically active, atypical and uncertain malignant potential leiomyomas. A histological criterion was presented in this study for diagnosis of smooth muscle tumors of the uterus. Forty-two cases originally diagnosed as uterine cellular leiomyomas were re-examined histologically, analyzed clinically and followed up. The results showed that among the 42 cases, there were 5 cases of cellular leiomyoma, 1 case of bizarre leiomyoma, 7 cases of atypical leiomyoma, 2 cases of tumors of uncertain malignant potential, 1 case of leiomyosarcoma and 26 cases of usual leiomyoma. The histological criteria of dense cellularity, cell atypia and nuclear mitosis showed a close correlation, but did not vary at different phases of menstrual cycle. Clinical features of borderline tumors were similar to those of usual leiomyomas, and their prognosis was also good. It is suggested that diagnosis of borderline smooth muscle tumors of the uterus should be made on the basis of three histological characteristics, including cellular density, cell atypia and nuclear mitotic figures. Management of the borderline cases seems to be the same as that of usual leiomyoma, but a further study may be necessary.
在平滑肌瘤和平滑肌肉瘤之间存在一系列子宫交界性平滑肌肿瘤，包括富于细胞型、奇异型、有丝分裂活跃型、非典型型以及恶性潜能不确定型平滑肌瘤。本研究提出了一种用于诊断子宫平滑肌肿瘤的组织学标准。对42例最初诊断为子宫富于细胞型平滑肌瘤的病例进行了组织学复查、临床分析及随访。结果显示，在这42例病例中，有5例富于细胞型平滑肌瘤、1例奇异型平滑肌瘤、7例非典型平滑肌瘤、2例恶性潜能不确定型肿瘤、1例平滑肌肉瘤以及26例普通平滑肌瘤。细胞密集度、细胞异型性和核分裂象的组织学标准显示出密切相关性，但在月经周期的不同阶段并无变化。交界性肿瘤的临床特征与普通平滑肌瘤相似，其预后也较好。建议子宫交界性平滑肌肿瘤的诊断应基于细胞密度、细胞异型性和核分裂象这三个组织学特征。交界性病例的处理似乎与普通平滑肌瘤相同，但可能需要进一步研究。
