≉Ṧ䛺㛫ⴥ⣔⭘⒆(ᕼᑡ⭘⒆䜢ྵ䜐䛭䛾௚䜒䜝䜒䜝)኱㜰኱Ꮫ኱Ꮫ㝔་Ꮫ⣔◊✲⛉ඛ➃䝀䝜䝮་⒪Ꮫㅮᗙ๓⏣኱ᆅ௒ᅇᢅ䛖䝔䞊䝬
䞉PEComa/LAM
䞉UTROSCT䞉IMT䞉BCOR␗ᖖ䜢క䛖⫗⭘䞉Adenomyoma

䞉Mullerian adenosarcoma㐣ཤ䠑ᖺ㛫䛾ᒎ㛤䞉䛂≉Ṧ䛺䛃䛂䝬䜲䝘䞊䛺䛃䛂䛒䜛ព࿡䜸䝍䜽㊃࿡ⓗ䛺䛃⑓ኚэศᏊ⏕≀Ꮫⓗ䛺▱ぢ䛜⵳✚䛥䜜䛶䛝䛯䞉⫼ᬒ䛻䛿FFPE᳨య䜢⏝䛔䛶኱つᶍ㑇ఏᏊ䝟䝛䝹䜢ᅇ䛫䜛䜘䛖䛻䛺䛳䛯䛣䛸䛜䛒䜛э䛂⑓⌮་䛾຺䛃䛿୙せ䠛䠛䞉᪂つ䛾⼥ྜ㑇ఏᏊ䛜ከᩘሗ࿌䛥䜜䛶䛝䛶䛔䜛э᳨ฟ⣔䛾ၥ㢟

PEC (perivascular epithelioid cell) proliferation

PEComa: ⭘⒗ᙧᡂᛶ⑓ኚ, ༢Ⓨ

LAM (lymphangioleiomyomatosis): ከ୰ᚰᛶ, ⭘⒗ᙧᡂ䛿⛥PEComa (perivascular epithelioid cell tumor)䞉፬ே⛉㡿ᇦ䛾୰䛷䛿Ꮚᐑ䛻᭱䜒ዲⓎ䞉⤖⠇ᛶ◳໬⑕䛻ྜే䛩䜛⑕౛䛒䜚䞉ቃ⏺᫂░䛺䜒䛾,tongue-like infiltration䜢♧䛩䜒䛾䛜䛒䜛
䞉PEC䛾ୖ⓶ᵝቑṪ䛜key finding䞉ᖹ⁥➽䝬䞊䜹䞊䠄SMA, desmin, caldesmon䛺䛹)䛸䝯䝷䝜䝃䜲䝖⣔䝬䞊䜹䞊䠄HMB45, Melan-A, MiTF䛺䛹)䛾ඹⓎ⌧䛜デ᩿䛻᭷⏝䞉Benign, uncertain malignant potential, malignant䛸ศ䛡䜛ᇶ‽䛜ᥦၐ䛥䜜, GYN௙ᵝ䛻ᨵኚ䛥䜜䛯䜚䜒䛧䛶䛔䜛䛜,ணᚋண ⢭ᗘ䛿ప䛔䞉mTOR㜼ᐖ⸆䛾㐺ᛂ䛻䛺䜛䛾䛷,ᖹ⁥➽⭘⒆䛸䛾㚷ู䛜㔜せPEComa (perivascular epithelioid cell tumor)Ꮡᅾ䜢㢌䛾∦㝮䛻䛚䛔䛶䛚䛟䛣䛸䛜㔜せ䛂䛱䜗䛳䛸⾑⟶䛾ศᕸ䛜ኚ䛺leio??䛃䛸ᛮ䛳䛯䜙せὀព

PEComa (perivascular epithelioid cell tumor)

PEComa (perivascular epithelioid cell tumor)

PEComa (perivascular epithelioid cell tumor)

HMB45

82F82FSMAHMB-45

HMB-45

PEComa (perivascular epithelioid cell tumor)ᝏᛶᗘ䛾ᇶ‽䠄GYN⏝䛻ᨵኚ by Schoolmaster et al.)Benign/uncertain malignant
potential௨ୗ䛾䛖䛱䛾4㡯┠ᮍ‶
䞉Ӎ5cm
䞉High-grade atypia
䞉Mitoses > 1/50HPF
䞉Necrosis
䞉LVIMalignant䠐㡯┠௨ୖBennet䜙䛿䛂䠏㡯┠䛃䜢threshold䛻䛧䛺䛔䛸aggressive
behavior䛾PEComa䜢ᣠ䛘䛺䛔䛸䛔䛖⥆ሗ䜢᭱㏆ฟ䛧䛯䛣䛾ᡭ䛾ศ㢮䠄≉䛻ᩘ༑౛⛬ᗘ䛾evidence䜢䜒䛸䛻ᥦၐ䛥䜜䛯䜒䛾䠅䛻᏶⎍䜢ồ䜑䜛䛾䛿㞴䛧䛔

PEComa (perivascular epithelioid cell tumor)

䞉TFE3: 2䡚3๭䛾⑕౛䛷IHC㝧ᛶ䛸䛺䜛䛜, fusion⮬య䛿⛥
Folpe et al. AJSP, 2005
Schoolmaster et al. AJSP, 2014
Bennet et al. AJSP, 2018

䞉RAD51B fusion䠖᪂つfusion䛸䛧䛶ሗ࿌䛥䜜䛯䛜, 㢖ᗘ䛿⛥Bennet et al. AJSP, 2018

LAM (Lymphangioleiomyomatosis)䞉Ꮚᐑ䛾LAM䛿୍⯡ⓗ䛻ቃ⏺୙᫂░䛷୙つ๎䛺ศᕸ䜢♧䛩䞉䝇䝸䝑䝖≧䛾䝇䝨䞊䝇䛜≉ᚩⓗ䞉⫵LAMᝈ⪅䛾Ꮚᐑ䞉௜ᒓჾ䛻䛿㧗㢖ᗘ䛻LAM⑓ኚ䛜᳨ฟ䛥䜜䜛䛸䛔䛖ሗ࿌䛜䛒䜚,඲㌟䛻ᗈ䛜䜛PEC䛾㉳※䛜㦵┙䛻䛒䜛ྍ⬟ᛶ䛜ᣦ᦬䛥䜜䛶䛔䜛Hayashi et al. AJSP, 2011

47F㻌㻠㻟㻲㻌⫵㻸㻭㻹䛾᪤ 䛒䜚㻌Ꮚᐑ㻌㻌

䝸䞁䝟⠇㻌

๭㠃㻌

Uterine tumor resembling ovarian sex cord-stromal tumors (UTROSCT)䞉༸ᕢ䛾⢭⣴㛫㉁⣽⬊⭘⒆ᵝ䛾ീ䜢࿊䛩䜛Ꮚᐑ⭘⒆䞉䛹䛾⛬ᗘ䇾resemble”䛧䛶䛔䛯䜙UTROSCT䛸䛩䜛䛾䛜᭕᫕䛷, ≉䛻endometrial stromal tumor with sex cord-likeelements (ESTSCLE) 䛸䛾㚷ู䛜ၥ㢟䛸䛺䜛䛣䛸䛜䛧䜀䛧䜀䞉IHC䛷䛿Inhibin, calretinin, SF-1, FOXL2䛸䛔䛳䛯sex cord䝬䞊䜹䞊䛜ᰁ䜎䜛䛜, FOXL2䜔Dicer-1䛾ኚ␗䛿䛺䛔эᮏ㉁ⓗ䛻䛿granulosa cell tumor䜔Sertoli cell tumor䛾Ꮚᐑ䝞䞊䝆䝵䞁䛷䛿䛺䛔
Irving et al. Mod Pathol, 2006de Leval et al. AJSP 2010
Chiang et al. AJSP, 2015
Croce et al. Int J Gyn Pathol, 2016

InhibinCalretinin

Uterine tumor resembling ovarian sex cord-stromal tumors (UTROSCT)䞉JAZF1⼥ྜ㑇ఏᏊ䜔ESTSCLE䛻㧗㢖ᗘ䛻ㄆ䜑䜙䜜䜛PHF1⼥ྜ㑇ఏᏊ䛿᳨ฟ䛥䜜䛺䛔
эUTROSCT䛿low-grade ESS䛸䛿␗䛺䜛⭘⒆⩌䛛
Staats et al. AJSP, 2009
Chiang et al. AJSP. 2011䞉᭱㏆䛻䛺䛳䛶UTROSCT䜢≉ᚩ䛵䛡䜛⫼ᬒ㑇ఏᏊ␗ᖖ䛸䛧䛶NCOA2/3⼥ྜ㑇ఏᏊ䛜ሗ࿌䛥䜜䛯(ESR1-NCOA3, ESR1-NCOA2, GREB1-NCOA2)

Dickson et al. AJSP 2019䞉ู䛾䜾䝹䞊䝥䛜GREB1-CTNNB1⼥ྜ㑇ఏᏊ䜢᭷䛩䜛
UTROSCT䛾1౛䜢ሗ࿌
Croce et al. Genes Chromosomes and Cancer, 2019
UTROSCT䛸ESTSCLE䛿ศᏊ⏕≀Ꮫⓗ䛻༊ู䛥䜜䛴䛴䛒䜛In䡂amatory myofibroblastic tumor (IMT)䞉⅖⑕⣽⬊ᾐ₶䜢క䛖Myxoid䛺㛫ⴥ⣔⭘⒆䜢ぢ䛯䜙DD䡔䛻䞉ALK␗ᖖ䛾᳨⣴䛻䜘䛳䛶ᩚ⌮䛜㐍䜣䛰ឤ䛜䛒䜛䠄௨๓䛻myxoid䛺STUMP䜔leiomyosarcoma䛸䛥䜜䛶䛔䛯⑕౛䛾୍㒊䛜IMT䛷䛒䜛ྍ⬟ᛶ)эALK-positivity䛜ᐇ㉁ⓗ䛻diagnostic䞉Desmin, SMA, CD10, ER, PgR䛿䛔䛪䜜䜒variably positive䞉୍㒊䛿Ꮚᐑእ㐍ᒎ,෌Ⓨ,㌿⛣䜢䛝䛯䛩
Rabban et al. AJSP 2005
Shintaku et al. Pathol Int, 2006
Parra-Herran et al. AJSP, 2015
Parra-Herran et al. AJSP, 2016
Deverearux et al. AJSP 2019
Mohammad et al. AJSP 2019In䡂amatory myofibroblastic tumor (IMT)Ꮡᅾ䜢㢌䛾∦㝮䛻䛚䛔䛶䛚䛟䛣䛸䛜㔜せ䛂⅖⑕䜢క䛖myxoid䛺leio?䛃䛸ᛮ䛳䛯䜙せὀពIn䡂amatory myofibroblastic tumor (IMT)In䡂amatory myofibroblastic tumor (IMT)In䡂amatory myofibroblastic tumor (IMT)ALKBCOR㛵㐃⭘⒆
䐟 ZC3H7B-BCOR⼥ྜ㑇ఏᏊ䞉Spindle cell୺య䛾ቑṪ䞉Myxoid stroma䞉᰾␗ᆺ䠖mild to moderate䞉Mitosis: ⥲䛨䛶ከ䜑䞉CD10, Cyclin D1: +䞉ER, PgR: variable
䞉LG-ESS䜘䜚䛿ணᚋ䛜ᝏ䛔Panagopoulos et al. Genes Chromosomes andCancer, 2013
Hoang et al. AJSP, 2017
Lewis et al. Mod Pathol, 2018

Hoang et al. AJSP, 2017

Hoang et al. AJSP, 2017

Hoang et al. AJSP, 2017

Hoang et al. AJSP, 2017

Hoang et al. AJSP, 2017

BCOR㛵㐃⭘⒆
䐟 ZC3H7B-BCOR⼥ྜ㑇ఏᏊ䞉Spindle cell୺య䛾ቑṪ
䞉Myxoid stroma䞉᰾␗ᆺ䠖mild to moderate䞉Mitosis: ⥲䛨䛶ከ䜑䞉CD10, Cyclin D1: +䞉ER, PgR: variable
䞉LG-ESS䜘䜚䛿ணᚋ䛜ᝏ䛔Panagopoulos et al. Genes Chromosomes andCancer, 2013
Hoang et al. AJSP, 2017
Lewis et al. Mod Pathol, 2018

䐠BCOR internal tandem duplication䞉ᚑ᮶䛾ᇶ‽䛷䛿high-grade ESS䛸䛥䜜䛶䛔䛯䠍౛䛸undifferentiated sarcoma䛸䛥䜜䛶䛔䛯2౛䛾ሗ࿌䞉ⱝᖺ (ᖹᆒ24ṓ)䞉ᆒ୍䛺spindle cell䠇epithelioid/round cell䞉Mitosis: ⥲䛨䛶ከ䜑䞉CD10: negative or focal +Marino-Enriquez et al. AJSP 2018
䞉Cyclin D1: +䛔䛪䜜䜒⠊␪䛸䛧䛶䛿High-grade ESS䛛, 䛸䛔䛖䛸䛣䜝䛷㆟ㄽ䛒䜚Ꮚᐑ㛫ⴥ⣔⭘⒆㛵㐃⼥ྜ㑇ఏᏊ
JAZF1/SUZ12YWHAE/NUTM2A 
JAZF1/PHF1
YWHAE/NUTM2B
EPC1-PHF1
EPC1-SUZ12
EPC1-BCOR
EPC2-PHF1
ZC3H7B-BCOR
ALK
BRD8-PHF1
MEAF6-PHF1
TPM3-NTRK1
LMNA-NTRK1
TPR-NTRK1RBPMS-NTRK3
GREB1-NCOA2
ESR1-NCOA2
ESR1-NCOA3
MBTD1-CXorf67
EWSR1-FLI1
EWSR1-WT1
ASPSCR1-TFE3
GREB1-CTNNB1
BCOR internal tandem duplicationḟ䛛䜙ḟ䜈䛸ሗ࿌䛥䜜䛶䛔䜛ຠ⋡Ⰻ䛟ゎᯒ䛷䛝䜛᪉ἲ,యไ䛾☜❧䛜㔜せ䛔䜟䜖䜛biphasic lesion

Adenomyoma

Mullerian adenosarcoma㛫ⴥ⣔⭘⒆䛺䛾䛛䠛Adenomyomaᩍ⛉᭩ⓗ䛻䛿䞉ᖹ⁥➽䛾⤖⠇≧,䛒䜛䛔䛿䝫䝸䞊䝥≧䛾ቑ⏕ᕢ䜢⫼ᬒ䛻␗ᆺᛶ䛻ஈ䛧䛔⭢⟶䛜ᩓᅾᛶ䛻ศᕸ䞉⭢ୖ⓶䛾㐪䛔䛻䜘䛳䛶endocervical type䛸endometrioidtype䜢༊ู䛩䜛䛣䛸䜒䛒䜛䞉Polypoid䛺⑓ኚ䛸➽ᒙෆ⑓ኚ䛾㉁ⓗ䛺ᕪ䛻㛵䛩䜛᳨ウ䛿୙༑ศ䞉➽ᒙෆendometrioid type㻌 adenomyoma䛾ሙྜ䇾nodularadenomyosis”䛸䛾␗ྠ䛜䛧䜀䛧䜀ၥ㢟䛻䛺䜛→䛂┿䛾⭘⒆䛺䛾䛛䛃䛸䛔䛖㆟ㄽ䛻㣗䛔㎸䜏⤖⠇໬௬ㄝ㣗䛔㎸䜏⤖⠇໬௬ㄝ⟶⭍ᵝᡂศ䛜㣗䛔㎸䜣䛷䛟䜛䛸,࿘ᅖ䛾ᖹ⁥➽䛜཯ᛂᛶ䛻ቑ⏕䛧䛶,⤖⠇≧⑓ኚ䜢స䜛㣗䛔㎸䜏⤖⠇໬௬ㄝ⟶⭍ᵝᡂศ䛜㣗䛔㎸䜣䛷䛟䜛䛸,࿘ᅖ䛾ᖹ⁥➽䛜཯ᛂᛶ䛻ቑ⏕䛧䛶,⤖⠇≧⑓ኚ䜢స䜛Adenomyoma䛸䛥䜜䜛䜒䛾䛾୍㒊䛿adenomyosisᡂศ䛻ᑐ䛩䜛⤖⠇≧䛾཯ᛂ䛰䜝䛖
䛯䛰䛧,,,,

Adenomyoma䛾㑇ఏᏊ␗ᖖ䠄┤㏆䛾ሗ࿌䠅䞉21౛䛾adenomyoma䜢᳨ウ

䞉MED12ኚ␗ (c. 131G>A, p.G44D) 䜢2౛䛻᳨ฟ䞉Fumarate hydratase (FH) ኚ␗䛜᳨ฟ䛥䜜䛯䠍౛→㠀⭘⒆ᛶ⤌⧊䛷䜒ኚ␗᳨ฟ→Herediary leiomyomatosis and renal cell cancre(HLRCC) syndrome䛷䛒䜛䛣䛸䛜♧၀䛥䜜䛯
Heikkinen et al. Human Reprod Open, 2018ᑡ䛺䛟䛸䜒୍㒊䛿┿䛾⭘⒆䛷䛒䜛

䇾Adenomyomatous polyp”
䞉Polypoid䛺adenomyoma䛺䛾䛛,adenomyoma䛸䛿␗䛺䜛⑓ኚ䛸䛧䛶adenomyomatous polyp䜢ᐃ⩏䛩䜛䛾䛛䠖㞴䛧䛔⑓ኚ䜒ᑡ䛺䛛䜙䛪䛒䜛

52F䇾Adenomyomatous polyp”
䞉Polypoid䛺adenomyoma䛺䛾䛛,adenomyoma䛸䛿␗䛺䜛⑓ኚ䛸䛧䛶adenomyomatous polyp䜢ᐃ⩏䛩䜛䛾䛛䠖㞴䛧䛔⑓ኚ䜒ᑡ䛺䛛䜙䛪䛒䜛䞉┤㏆䛾䇾adenomyomatous polyp” 84౛䛾᳨ウ䛷䛿,䜋䜌඲౛䛜CD10㝧ᛶ,Desmin㝧ᛶ䛷, MED12ኚ␗䛿᳨ฟ䛥䜜䛪
Strickland et al. Human Pathol, 2019

“Adenomyomatous polyp”䛿ᖹ⁥➽ศ໬䛾㢧ⴭ䛺
endometrial polyp䠄㠀⭘⒆ᛶ⑓ኚ)䛾ྍ⬟ᛶ㣗䛔㎸䜏⤖⠇໬௬ㄝ

APAM䛾ヰ䛾๓䛻endometrial carcinoma䛾1౛䜢66Fᓙ㒊䛻䛿䜽䝑䝅䝵䞁䛸䛺䜛㛫㉁䛜䛺䛔

ᓙ㒊䛻䛿䜽䝑䝅䝵䞁䛸䛺䜛㛫㉁䛜䛺䛔

Atypical polypoid adenomyoma (APAM)䞉⢓⭷ୗ⭘⒗䛸䛧䛶⏕䛨䜛 䠄୺䛻ᓙ㒊䠅䞉ᖹ⁥➽䛾ቑ⏕ᕢ䜢⫼ᬒ䛻୙つ๎䛺ෆ⭷⭢䛾ቑṪ䛜ㄆ䜑䜙䜜䜛
䞉Squamous morule䛾ᙧᡂ䛜┠❧䛴䞉⏕᳨,ᥙ∐᳨య䛷䛿,➽ᒙᾐ₶䜢♧䛩endometrioidcarcinoma䛸䛾㚷ู䛜㞴䛧䛔䛣䛸䛜䛒䜛
䞉䇾APAM䛛䜙⏕䛨䛯endometrioid carcinoma”䛸䛔䛖ሗ࿌䜒ᑡ䛺䛛䜙䛪䛒䜛

34FAtypical polypoid adenomyoma (APAM)ୖ⓶ᡂศ䛻㑇ఏᏊ␗ᖖ䛒䜚
β-catenin

mTOR

Nemejcava et al. AJSP, 2015

PTEN

APAM䛿䇾localized form of atypical hyperplasia”䛸䛧䛶ᤊ䛘䜛䛾䛜䜘䛔䛾䛷䛿䛺䛔䛛Atypical polypoid adenomyoma (APAM)

䜽䝑䝅䝵䞁䛾䛺䛔ᓙ㒊䛷,low grade䛾⭢ୖ⓶䛾⭘⒆ᛶቑṪ䛜⏕䛨,䛂㣗䛔㎸䜏⤖⠇໬䛃䛧䛯⑓ኚ䠛(Low grade) Mullerian adenosarcoma䞉Ꮚᐑෆ⭍䛻✺ฟ䛩䜛䛣䛸䛜ከ䛔䞉㛫ⴥ⣔ᡂศ䛾⣽⬊␗ᆺ䛜ஈ䛧䛔⑕౛䛷䛿,ⴥ≧䛾ᵓ㐀䜔⭢⟶࿘ᅖ䛾⣽⬊ᐦᗘ䛾ୖ᪼䛜デ᩿䛾key䛸䛺䜛. 䛜, 䛣䛾䜘䛖䛺ኚ໬䛜ᒁᡤⓗ䛺⑕౛䜒ከ䛟, ⏕᳨,ᥙ∐䛷䛿デ᩿䛜ᅔ㞴䛺䛣䛸䜒䛧䜀䛧䜀.
䞉䇾Sarcomatous overgrowth”䠖ᴫᛕ䛸䛧䛶䛿᭷ྡ䛰䛜,䛹䛣䛛䜙䛭䛖࿧䜆䛾䛛୙᫂☜䛺㠃䛒䜚

䞉Sarcomatous overgrowthᡂศ䛜㧗ᝏᛶᗘ䜢♧䛧,ᗈ䛔⠊ᅖ䛻㐍ᒎ䛩䜛䛸, ⴥ≧ᵓ㐀䛺䛹䛾Mullerianadenosarcoma䜙䛧䛥䛜ᾘኻ䛩䜛䛣䛸䜒䛒䜛

59F(Low grade) Mullerian adenosarcoma
䞉28%䛻MDM2/CDK4䛾ቑᖜ䞉72%䛻PIK3CA/AKT/PTEN⤒㊰䛾␗ᖖ䞉p53␗ᖖ䛿sarcomatous overgrowth⑕౛䛾୍㒊䛾䜏䛻ぢ䜙䜜䜛
Howitt et al. J of Pathol, 2015

䞉19౛䛾᳨ウ䛷, DICER1, FGFR2, KMT2Cኚ␗, NCOA⼥ྜ㑇ఏᏊ䜢䠎౛䛪䛴᳨ฟэ䝦䝔䝻䛺⭘⒆⩌䞉㑇ఏᏊ␗ᖖ䛿㛫ⴥ⣔ᡂศ䛾䜏䛻Ꮡᅾ䠄䝬䜲䜽䝻䝎䜲䝉䜽䝅䝵䞁)

(Low grade) Mullerian adenosarcoma㑇ఏᏊ␗ᖖ䛾ほⅬ䛛䜙䛿䝦䝔䝻䛺⭘⒆⩌䛸䛔䛖༳㇟

“Variant adenosarcoma (tentative)” (᪂ᴫᛕ)ྎ‴䛾䜾䝹䞊䝥䛜ከᵝ䛺biphasic tumor䛻㛵䛧䛶
MED12ኚ␗䛾᳨⣴䜢䛧䛶䛔䛯㐣⛬䛷,䛂MED12ኚ␗䛻≉ᚩ䛵䛡䜙䜜䜛≉␗䛺⭘⒆⩌䛃䜢ㄆ㆑䛧,䇾Variantadenosarcoma (MED12-mutated adenosarcoma-liketumor”䛸䛧䛶ሗ࿌.
Yuan et al. Hitopathology, 2017䞉䠏౛୰䠎౛䛿polypoid,1౛䛿᏶඲䛻ቨෆ䞉䛔䛪䜜䜒➽ᒙ῝㒊䜈ྥ䛛䛳䛶୙つ๎䛻ᾐ₶䞉ቑṪ䛧䛶䛔䜛㛫ⴥ⣔ᡂศ䛿䇾fibrous to somewhat myoid appearance”
䞉㛫ⴥ⣔⣽⬊䛾␗ᆺᛶ䠖↓䠄䡚䛤䛟㍍ᗘ)䞉⭢⟶࿘ᅖ䛾⣽⬊ᐦᗘ䛾ቑຍ䠖↓䞉ⴥ≧ᵓ㐀䠖↓䞉㏆ഐ䛻adenomyosis䛒䜚䞉Adenomyosis䜢䛴䛯䛳䛯ᗈ䛜䜚䛾䜘䛖䛻ぢ䛘䜛㡿ᇦ䜒䛒䜛䞉ቨ䛾ཌ䛔⾑⟶䛾௓ᅾ䛒䜚䞉◪Ꮚ໬䛧䛯㡿ᇦ䛒䜚䞉⬦⟶౵く䛒䜚୍⯡ⓗ䛺low grade Mullerian adenosarcoma䛸䛿␗䛺䜛Yuan et al.
Hitopathology,2017

High grade Mullerian adenosarcoma

Hodgson et al. AJSP, 2017䞉㛫ⴥ⣔ᡂศ䛜㧗␗ᆺᗘ䜢♧䛩adenosarcoma, 9౛䜢ゎᯒ䞉Sarcomatous overgrowth䛿䛖䛱䠎౛䞉7౛(78%)䛻TP53␗ᖖ䛜᳨ฟ䛥䜜䛯
Sarcomatous overgrowth䛜䛺䛛䛳䛯䛸䛧䛶䜒,high gradesarcomaᡂศ䛾Ꮡᅾ䛿㔜せ䛷,デ᩿䛻཯ᫎ䛥䛫䜛䜉䛝䠛э᳨ฟ䛻p53䛾IHC䛜᭷⏝䛷䛿䠛p53

AdenosarcomaᏊᐑయ㒊ὸᒙ䛻䛚䛔䛶ከ✀ከᵝ(ᝏᛶᗘ䜒Ⰽ䚻)䛺spindlecell䛾ቑṪ䛜㉳䛝,㛤ᨺ⭍᪉ྥ䛻䜒䛣䜒䛣䛧䛶䛔䛟⑓ኚ

Biphasic lesion⥲ᣓAdenomyoma୍㒊䛿㛫ⴥ⣔⭘⒆

Adenomyomatous polyp㠀⭘⒆

APAMୖ⓶⣔⭘⒆

Adenosarcoma

㛫ⴥ⣔⭘⒆ㅰ㎡㈗㔜䛺⑕౛䜢ᥦ౪䛧䛶䛟䛰䛥䛳䛯ᰗ஭ᗈஅඛ⏕,ᥦᔱ┾ேඛ⏕, 㔝ཱྀᐶᏊඛ⏕䛻ᚰ䜘䜚ឤㅰ⏦䛧ୖ䛢䜎䛩䚹