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首页> 外文期刊>Indian Journal of Pathology and Microbiology >Uterine smooth muscle tumors of uncertain malignant potential and atypical leiomyoma: A morphological study of these grey zones with clinical correlation
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Uterine smooth muscle tumors of uncertain malignant potential and atypical leiomyoma: A morphological study of these grey zones with clinical correlation

机译：恶性潜能不确定的子宫平滑肌瘤和非典型平滑肌瘤：这些灰色区域的形态学研究与临床相关性

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Objectives: To study the histological features in uterine STUMP, and atypical leiomyomas (AL), and to correlate with clinical outcome. Materials and Methods: From January 2004 to August 2010, a total of 21 cases were retrieved from records, labeled as STUMP(7), AL (5), AL with low risk of recurrence (2), smooth muscle tumor of low malignant potential (STLMP) (2), and symplastic leiomyoma (5). The slides were reviewed for coagulative tumor cell necrosis (CTCN), hyaline necrosis/ infarction type necrosis, presence and degree of cytological atypia, mitotic activity, epithelioid morphology and myxoid features. The other characteristics (such as size, circumscription, individual tumor cell necrosis), were noted, wherever available. Results: The mean age was 45 years (median 46; range 24-67 yrs). CTCN was seen in 2 cases on examination of additional material; wherein a revised diagnosis of leiomyosarcoma had been given. Infarction type necrosis and individual cell necrosis was seen in 2 and 3 cases, respectively. Mitoses were less than 5/10hpf in all the cases. One of the tumours labeled as STUMP also had concurrent endometrial adenocarcinoma. Follow up: Follow-up was available in 11 cases (52.3%). One patient had died. (cause not known). In 10 patients, the follow-up ranged from 4 to 56 months (mean 20.9 months; median 15 months) nine patients were alive and well. One patient (labeled STLMP) had metastatic liver disease 3 yrs after the primary surgery, at the last follow-up. Conclusions: 1) There is an overlap in using the terminologies as STUMP, AL, AL with low risk of recurrence, AL with low malignant potential. A designation of STUMP does convey a category of borderline malignancy to the gynecological surgeons. Most behave in a benign fashion and follow-up without adjuvant therapy is currently recommended. Critical evaluation of coagulative tumor necrosis is essential. Follow-up remains a challenge in our setting.
机译：目的：研究子宫STUMP和非典型平滑肌瘤（AL）的组织学特征，并与临床结果相关。资料与方法：自2004年1月至2010年8月，共检索到21例病例，分别为STUMP（7），AL（5），低复发风险（2），恶性程度低的平滑肌肿瘤（STLMP）（2）和增生性平滑肌瘤（5）。对载玻片的凝结性肿瘤细胞坏死（CTCN），透明质坏死/梗塞型坏死，细胞学非典型性的存在和程度，有丝分裂活性，上皮样形态和粘液样特征进行了审查。注明了其他特征（如大小，限制，单个肿瘤细胞坏死）。结果：平均年龄为45岁（平均年龄46岁;范围24-67岁）。在检查补充材料的2例中发现了CTCN。其中已经给出了平滑肌肉瘤的修订诊断。 2例和3例分别见梗死型坏死和单个细胞坏死。在所有情况下，线粒体均小于5 / 10hpf。标记为STUMP的肿瘤之一也有并发子宫内膜腺癌。随访：11例（52.3％）可以随访。一名病人死亡。 （原因未知）。在10例患者中，随访时间为4到56个月（平均20.9个月;中位时间为15个月），其中9例患者还活着并且状况良好。在最后一次随访中，一名患者（标记为STLMP）在初次手术后3年转移了肝病。结论：1）STUMP，AL，AL复发风险低，AL恶性潜能低的术语存在重叠。 STUMP的名称确实将一线恶性肿瘤传达给妇科医生。大多数患者表现为良性，目前建议不进行辅助治疗的随访。对凝固性肿瘤坏死的严格评估至关重要。后续工作仍然是我们面临的挑战。

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