Uterine leiomyoma with massive lymphoid infiltration:a clinicopathological analysis of four cases
Purpose To investigate the clinicopathological features and significance of the uterine leiomyoma with massive lymphocytic infiltration(ULLI).Methods Four cases of uter-ine leiomyoma with massive lymphocyte infiltration were collect-ed for histological observation,immunohistochemical staining,EBER in situ hybridization,gene clonality analysis.Its clinical and pathological characteristics were analyzed,and relevant liter-atures were reviewed.Results All the patients clinically pres-ented with irregular vaginal bleeding and uterine masses,and underwent surgical resection of the tumors.These tumors,simi-lar to the common leiomyomas,had firm,whorled,white,pink or gray cut surfaces.Histological examination showed dense and diffuse lymphoid infiltration between the interwoven bundles of fusiform smooth muscle cells,mainly small lymphocytes,accom-panied by the formation of lymphoid follicles,almost masking the nature of the tumors.Immunohistochemical staining showed that the fusiform leiomyoma cells were positive for actin,α-SMA,desmin,and h-caldesmon.The infiltrated lymphocytes were positive for CD45,CD45RO,CD2,CD3,CD4,CD8,and TIA-1.The lymphatic follicles were positive for CD20,CD79a,and PAX5.EBER in situ hybridization was negative in all ca-ses.BIOMED-2 PCR analysis showed that 3 cases had clonal T cell receptor gene rearrangement,and 1 case with concomitant immunoglobulin gene rearrangement.The patients were followed up for 6-108 months and had no evidence of recurrence.Con-clusion ULLI is a rare morphological change in uterine leiomy-oma,where the extensive lymphocytic infiltration may mask the nature of the tumors.Awareness of this histological phenomenon in leiomyoma is of most importance to avoid misdiagnosis of lym-phoma.
万方数据
维普
