恶性苗勒管混合瘤临床病理分析

Clinical and Pathological Analysis of Malignant Müllerian Mixed Tumor

摘要: 目的：探讨子宫恶性苗勒管混合瘤(Malignant Müllerian Mixed Tumor, MMMT)的临床病理学特征、免疫表型、诊断及鉴别诊断。方法：采用HE染色及免疫组化染色对4例MMMT进行检测并复习相关文献。结果：肿瘤由上皮和间质两种成分构成，2例上皮成分为子宫内膜样腺癌，1例间质成分为子宫内膜间质肉瘤，1例间质成分为高级别肉瘤。免疫表型：上皮成分CKpan (2/2)，间质成分vimentin (2/2)、CD10 (2/2)均阳性，上皮成分和间质成分p16 (2/2)和p53 (2/2)均阳性。结论：子宫MMMT是一种少见的高度恶性上皮和间质混合性肿瘤，具有独特的临床病理学特征，预后差。

Abstract: Objective: To investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of malignant mixed Müllerian tumor (MMMT) of the uterus. Methods: Four cases of MMMT were examined by HE staining and immunohistochemical staining, and relevant literatures were reviewed. Results: The tumors were composed of two components, namely epithelial and stromal components. In 2 cases, the epithelial component was endometrioid adenocarcinoma. In 1 case, the stromal component was endometrial stromal sarcoma, and in another 1 case, the stromal component was high-grade sarcoma. Immunophenotype: CKpan (2/2) was positive in the epithelial component, while vimentin (2/2) and CD10 (2/2) were positive in the stromal component. Both p16 (2/2) and p53 (2/2) were positive in both the epithelial and stromal components. Conclusion: Uterine MMMT is a rare, highly malignant mixed tumor of epithelium and stroma with unique clinicopathological features and a poor prognosis.