子宫乳腺型肌纤维母细胞瘤一例并文献复习

doi:10.12280/gjfckx.20220933

摘要/Abstract

摘要：

乳腺型肌纤维母细胞瘤（mammary-type myofibroblastoma，MTMF）是一种罕见的发生在乳腺外的良性间叶源性肿瘤，由弥漫分布的短梭形细胞、数量不等的成熟脂肪细胞及粗大的胶原纤维束组成。免疫表型方面，MTMF中的梭形细胞弥漫性表达CD34和结蛋白。一旦确诊，无论其大小或位置如何，都应手术切除，且术后定期复查。报告1例51岁自然绝经后子宫MTMF病例，术前及术中被误诊为子宫肌瘤。依据病情及患者意愿行经腹全子宫及双附件切除术，最终通过术后免疫组织化学染色检查确诊为子宫MTMF。现随访18个月，患者状况良好，无特殊不适。通过回顾性分析本例患者诊治过程及经验，以期为临床诊治提供参考。

关键词: 子宫肿瘤, 肿瘤, 肌组织, 乳腺, 人, 病理学, 免疫组织化学, 诊断, 治疗

Abstract:

Mammary-type myofibroblastoma (MTMF) is a rare benign mesenchymal-derived tumor that occurs outside of the breast and is composed of diffusely distribution of spindle cells, varying numbers of mature fat cells and coarse collagen fiber bundles. Immunophenotypically, the spindle cells in MTMF diffusely express CD34 and Desmin. Once diagnosed, regardless of its size or location, it should be surgically excised and regularly monitored postoperatively. This article reports a case of a 51-year-old postmenopausal woman with uterine MTMF, who was misdiagnosed as uterine leiomyoma preoperatively and intraoperatively. Based on the condition and patient′s wishes, total abdominal hysterectomy with bilateral salpingo-oophorectomy were performed, and MTMF was finally diagnosed by postoperative immunohistochemical staining and was followed up for 18 months with no specific discomfort. Through a retrospective analysis of the diagnosis and treatment process and experience of this case, this study aims to provide clinical reference for diagnosis and treatment.

Key words: Uterine neoplasms, Neoplasms, muscle tissue, Mammary glands, human, Pathology, Immunohistochemistry, Diagnosis, Therapy

席欣欣, 张林凤, 李佳. 子宫乳腺型肌纤维母细胞瘤一例并文献复习[J]. 国际妇产科学杂志, 2023, 50(4): 396-399.

XI Xin-xin, ZHANG Lin-feng, LI Jia. Uterine Mammary-Type Myofibroblastoma: A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2023, 50(4): 396-399.

图/表 6

图1 妇科超声图

图2 腹部CT平扫图

图3 全子宫大体标本

图4 子宫肿物病理图（HE染色×200）

图5 子宫肿物免疫组织化学染色图（MaxVisionTMHRP×100）注：A CD34阳性；B Desmin部分阳性；C ER弥漫阳性；D PR弥漫阳性。

图6 术后经阴道妇科超声图注：子宫缺如，阴道断端光滑，未见异常。

参考文献 14

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