目的:血管平滑肌瘤是一种良性血管周围肿瘤,通常累及四肢皮下组织,头部,和树干区域。它们很少涉及女性生殖道。本文分析了6例子宫血管平滑肌瘤的临床病理特征。
方法:对6例患者的常规切片进行回顾性分析,免疫组化标记为肌肉特异性肌动蛋白,h-caldesmon,desmin,进行CD10、WT-1、HMB-45和melan-A。
结果:6例中,肿瘤累及体部4例,宫颈肿瘤2例。严重的,所有肿瘤的切面均为旋切和充血.所有病例的显微镜检查均显示出局限性肿瘤,由良性血管周围平滑肌细胞的交错束组成,具有均匀分布的狭缝状血管(实心变体),以及表现出具有漩涡状的厚肌肉壁(静脉变体)的血管。仅2例可见许多扩张血管(海绵状变体)。免疫组织化学,所有病例的肌肉特异性肌动蛋白均为阳性,h-caldesmon,和Desmin。所有病例均为CD10和WT-1阴性,排除了子宫内膜间质瘤,HMB-45和melan-A阴性,排除了血管周围上皮样细胞瘤(子宫内膜间质瘤和血管周围上皮样细胞瘤均具有突出的血管,但具有不同的组织形态学)。在所有情况下,手术切除是治愈的,没有术中或术后并发症。所有案件的后续行动并不引人注目。
结论:由于世界卫生组织尚未将血管平滑肌瘤纳入子宫体和子宫颈间充质肿瘤的分类中,我们建议将其包含在分类中。
OBJECTIVE: Angioleiomyoma is a benign perivascular neoplasm commonly involving subcutaneous tissue of extremities, head, and trunk region. They rarely involve the female genital tract. This
study analyses clinicopathological features of 6 cases of uterine angioleiomyoma.
METHODS: Routine sections of 6 cases were reviewed and immunohistochemical markers namely muscle-specific actin, h-caldesmon, desmin, CD10, WT-1, HMB-45, and melan-A were done.
RESULTS: Of the 6 cases, 4 cases had tumor involving the corpus and 2 cases had tumor in the cervix. Grossly, all tumors had a whorled and congested cut surface. Microscopic examination of all the cases revealed circumscribed neoplasms composed of interlacing fascicles of benign perivascular smooth muscle cells with evenly distributed slit-like blood vessels (solid variant) along with vessels exhibiting thick muscular walls with swirling pattern (venous variant). In only 2 cases many dilated vessels were seen (cavernous variant). Immunohistochemically, all cases were positive for muscle-specific actin, h-caldesmon, and desmin. All cases were negative for CD10 and WT-1 ruling out endometrial stromal tumor and were negative for HMB-45 and melan-A ruling out perivascular epithelioid cell tumor (both endometrial stromal tumor and perivascular epithelioid cell tumor have prominent vessels but have different histomorphology). In all cases, surgical excision was curative and there were no intraoperative or postoperative complications. Follow-up of all the cases has been unremarkable.
CONCLUSIONS: As the World Health Organization has not included angioleiomyoma in the classification of mesenchymal tumors of uterine corpus and cervix, we recommend that it should be included in the classification.