去/未分化子宫内膜癌的肉瘤转化:一个认识不足的现象及诊断陷阱

摘要:去/未分化癌是一种侵袭性子宫内膜癌,尚未被充分认识,但可能占所有子宫内膜恶性肿瘤的9%。我们描述了3例未分化成分与肉瘤分化有关,其中2例以梭形细胞为特征,1例伴有异源性恶性软骨。3例中2例通过免疫组化检测证实错配修复缺失。这种现象之前没有被正式报道过,增加了误诊的可能性,尤其是活检标本中;鉴别诊断可能包括子宫内膜间质肉瘤和呈梭形形态的III级子宫内膜样腺癌。我们回顾了现有文献并提供鉴别诊断的策略,建议的抗体组合包括EMA,E-cadherin和错配修复蛋白,大约50%的病例中有错配修复蛋白表达缺失。

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