摘要:
目的:探讨子宫上皮样滋养细胞肿瘤(epithelioid trophoblasticumor,ETT)的临床病理特征和鉴别诊断。方法:对1例子宫ETT的临床和病理资料进行回顾分析,并结合文献讨论。结果:患者女性,30岁。经期延长、不规则阴道出血半年。大体见子宫左侧壁有一病灶,界限不清,呈腐鱼肉样,直径5 cm,伴出血、坏死。镜下肿瘤由单一型中间滋养细胞组成,排列成巢团状,位于玻璃样或嗜伊红色肿瘤坏死碎屑组织中,形成"地图样外观";瘤细胞中等大小,胞质透亮或嗜伊红色,细胞境界清楚,核圆形或卵圆形、核仁明显。肿瘤细胞AE1/AE3、p63和Ki-67均阳性,hCG部分阳性。结论:ETT是一种罕见的滋养细胞肿瘤,具有恶性的生物学行为,但恶性程度较低。应与子宫颈鳞状细胞癌及其他滋养细胞肿瘤等鉴别。
Abstract:
Objective:To investigate the clinicopathological features of epithelioid trophoblastic tumor (ETT) of the uterus with emphasis on its differential diagnosis.Methods:The clinicopathological data of 1 case of ETT was analyzed and the literature was reviewed.Results:The patient was a 30-year-old female with the symptoms of delayed menstruation and abnormal vaginal bleeding for half a year.Gross examination of the hysterectomy specimen revealed a limit-unclear lesion involving the left uterine wall.The tumor was 5 cm in size and was necrotic with areas of hemorrhage;microscopically,the tumor was composed of one type intermediate trophoblast cells arranged in nests and cords,which distributed in a geographical pattern with hyalinization or eosinophilic debris of tumor cell necrosis.The medium-sized tumor cells contained abundant eosinophilic or clear cytoplasm and distinct cell borders,round or oval nuclei with distinct nucleoli.Immunohistochemically,the tumor cells were positive for AE1/AE3,p63 and Ki-67,and partially positive for hCG.Conclusions:ETT is a rare gestational trophoblastic tumor that has malignant biological behavior of lower grade.It should be differentiated from cervical squamous cell carcinoma and other trophoblastic tumors.
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