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以下是引用ZZRR在2009-12-13 12:49:00的发言: 腺肉瘤 |
It is possible, but the chance is low based on growth pattern.
To made the dx of MMMT, the tubular or cord component sgould be strongly positive for CK and negative for sex cord markers.
这是可能的,但是依据这样的生长模式,这种可能性很小。
确定MMMT(腺肉瘤)的诊断,管状及索状成分,CK应该强阳性,而性索标记阴性。
To save money, CD10, caldemon (or desmin) and some sex cord markers (calretinin, CD99, inhibin) can be performed. One of sex cord markers should be positive in order to call endometrial stromal sarcoma with sex cord like elements, or UTROST
为节约钱,CD10,caldemon (或者 desmin) 和一些性索标记(calretinin, CD99, inhibin)应该被选用。既然称之为子宫内膜间质肉瘤伴性索样分化,那么标记性索的一种标记应该阳性。
Endometrial stromal tumor (uniform, oval shaped cells like proliferative endometrial stroma+small vescultures) with infiltrating borders=endometrial stromal sarcoma
Some photos demonstrat cord, trabecular, and sertoliform tubular structure=like ovarian sex-cord component
My impression is Low grade endometrial stroma sarcoma with sex cord like elements based on H&E photos above..
the main ddx: uterine tumor resemble ovarina sex-cord tumor.
IHC:
pck, ema (sex-cord component may be posiitve).
calretinin, CD99 or inhibin: should have some positivity in sex cord componnet.
SMA, desmin, or caldesmon to rule out smooth muscle tumor
CD10 for stroma component.
Very good case.
子宫内膜间质肿瘤(类似子宫内膜间质的卵圆形细胞+小血管?),有浸润性边界=子宫内膜间质肉瘤。
一些图片证实有索状,小梁状,线状,管状结构==性索样间质成分。
根据以上的图片,我的印象是低级别子宫内膜间质肉瘤伴性索分化。
主要鉴别诊断:类似卵巢性索肿瘤的子宫肿瘤。
免疫组化:
pck, ema :性索成分可能阳性
calretinin, CD99 or inhibin: 性索成分阳性.
SMA, desmin, or caldesmon :排除平滑肌肿瘤
CD10 :用于子宫内膜间质成分。.
非常好的例子。.