Recurrent M üllerian adenofibroma of uterus:a clinicopathologic study of 7 cases
10.3760/cma.j.issn.0529-5807.2014.05.008
- VernacularTitle:复发性子宫苗勒源腺纤维瘤临床病理分析
- Author:
Haiyan SHI
1
;
Xiaoduan CHEN
;
Xiaofei ZHANG
;
Caiyun ZHOU
;
Minghua YU
Author Information
1. 浙江大学医学院附属妇产科医院病理科
- Keywords:
Uterine neoplasms;
Mullerian ducts;
Adenofibroma;
Diagnosis,differential;
Recurrence
- From:
Chinese Journal of Pathology
2014;(5):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinicopathologic features and differential diagnosis of recurrent Müllerian adenofibroma ( MAF) of the uterus.Methods Clinicopathologic information of 7 cases of recurrent MAF of uterus was retrieved from January 1992 to April 2006 and compared with 12 cases of MAF without recurrence and 14 cases of low-grade Müllerian adenosarcoma ( MAS ). EnVision immunohistochemistry of estrogen receptor ( ER ) , progesterone receptor ( PR ) , smooth muscle actin (SMA), CD10, Ki-67 and p53 were performed in all cases.Results All cases of recurrent MAF of the uterus were polypoid , lobulated, and broad based mass arising from the corpus or cervix .Microscopically , the tumor consisted of benign epithelial and mesenchymal components with low mitotic activity (≤1/10 HPF) .The clinical and pathologic features of 3 recurrent tumors were similar to their primary tumors , while 4 cases of recurrent tumor presented with focally higher cellularity and mitotic activity , meeting the diagnostic criteria of adenosarcoma .The stromal expression patterns of ER , PR, SMA and p53 in recurrent MAF were similar to those of clinically benign MAF and low-grade MAS.Negative or focally positive stromal cell expression of CD10 was seen infrequently in recurrent MAF (1/7) and clinically benign MAF (1/12). In contrast, a moderate to strong CD10 staining was frequently seen in MAS (9/14, P <0.05).The difference of Ki-67-labeling index between MAF and MAS did not reach a statistical significance ( P >0.05 ) . Ki-67-labeling index increased in areas of periglandular stromal cuffing as compared with interglandular areas in all MAS cases , but it was not observed in either recurrent MAF or clinically benign MAF cases.Conclusions Recurrent MAF may be associated with aggressive behavior .It is difficult to distinguish MAF from low-grade MAS.CD10 and Ki-67 staining pattern in stromal cells may be helpful for the differential diagnosis .
