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- Uterine mass（子宫肿块）
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panzenggang 离线
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| 姓 名： | ××× | 性别： | Female | 年龄： | 68 |
| 标本名称： | Uterine mass | ||||
| 简要病史： | A 62-year-old G3P3 female complained of postmenopausal spotting for seven days. She was placed on Prempro with good response. An endometrial biopsy revealed proliferative endometrium. An ultrasound showed a thickened endometrium and a 7.0-cm fibroid. A hysterectomy was performed. | ||||
| 肉眼检查： | The uterus measures 7.0 × 7.0 × 6.5 cm and weighs 207 grams. A 4.5 × 5.5 cm well demarcated intramural mass is present with a homogeneously pale-tan, soft fleshy cut surface that is free of necrosis or hemorrhage. | ||||
女62岁，G3P3，绝经后少量出血数天。Prempro治疗反应好。内膜活检示子宫内膜增生。超声示宫壁增厚，一个肌瘤直径7cm。行子宫切除术。
子宫大小：7*7*6.5cm，重207g。宫壁内一个4.5*5.5cm的界清肿块，切面均质，灰白灰红色，质软，鱼肉样，无坏死和出血。（abin译）
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本帖最后由 于 2008-03-17 23:09:00 编辑
×参考诊断
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panzenggang 离线
- 帖子：189
- 粉蓝豆：480
- 经验：246
- 注册时间：2008-01-09
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Dear Zenggang,
I hope this note finds you well. I have not heard from you since our Colorado meet at USCAP meeting. I am sure I will see you next year in Boston. Thank you for sharing this fantastic case. Based on classic gross picture, morphology and immunoreactive profile, I am concerned about " Uterine Tumor resembling ovarian sex cord tumor (UTROSCT). Of course the differential is always ESTSCLE ( Endometrial stromal tumor with sex cord-like elements). Based on CD10 negativity, I favor the former, since 9 out of 10 ESS (endometrial stromal tumor) will be positive for CD10. Sometimes you can see focal CD10 positivity in typical UTROSCT cases. I would like to know if you have chance to run calretinin, CD99 and Melan A on this case.
For starter, I want to caution you to make UTROSCT diagnosis base on EM biopsy or curretting since so much overlapping features between ESS and UTROSCT. Clinically UTROSCT has much better prognosis than ESS. Whenever you deal with a dilemma like this case, you always think to order Calretinin, CD99 and Melan A.
Thanks again for sharing and I am looking forward for your final answer.
Bin
- 不坠青云之志，长怀赤子之心
