左心房動脈内膜肉腫の一例

To explore the clinical and pathological characteristics as well as immunophenotypes of arterial endometrial sarcoma, and to improve the understanding of this disease. Due to the poor efficacy of late stage radiotherapy and chemotherapy, early diagnosis and surgical eradication are of great significance.

Clinical data of a case of arterial intimal sarcoma occurring in the left atrium were summarized, HE and immunohistochemical staining were performed to observe its morphological and immunophenotypic characteristics, and relevant literature was reviewed.

The patient was a middle-aged female. Cardiac CT showed a local right bulging of the left atrial septum, while cardiac ultrasound showed an enlargement of the left atrium. Several moderately uneven echogenic tumor reflections were observed in the atrial cavity, with a large amplitude of oscillation. The local echo of the interventricular septum is thin and soft, forming a tumor like structure that swells towards the right atrium. Under the microscope, the tumor cells appear spindle shaped overall, with obvious cellular atypia. Nuclear division and sparse and dense areas of cells can be seen, with some areas showing mucinous stroma and others showing abundant cells growing around blood vessels. Immunohistochemistry confirmed MDM2 positivity.

Endometrial sarcoma is a rare malignant tumor that occurs in the endometrium and may originate from multifunctional stem cells beneath the endometrium. Endometrial sarcoma IS is often a high-grade undifferentiated sarcoma that can differentiate in multiple directions. Combining specific disease sites with morphological diagnosis is not difficult.