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a mass of fungal tissue that has spore-bearing structures embedded in it or on it
the dense colorless framework of a chloroplast
the supporting tissue of an organ (as opposed to parenchyma)
a usually malignant tumor arising from connective tissue (bone or muscle etc.); one of the four major types of cancer
of or relating to the endometrium

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肉腫(にくしゅ)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/23 20:48:06」(JST)

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Endometrial stromal sarcoma is a rare endometrial tumor arising from the stroma (connective tissue) of the endometrium rather than the glands. There are three grades for endometrial stromal tumors, as follows.^[1] It was previously known as endolymphatic stromal myosis because of diffuse infiltration of myometrial tissue or the invasion of lymphatic channels.^[2]

Endometrial stromal nodule[edit source | edit]

Endometrial Stromal Nodule

An endometrial stromal nodule is a noninfiltrative, circumscribed proliferation of endometrial stromal cells. The appearance of the cells is identical to normal stromal cells. This can only be differentiated from low-grade sarcoma by confirming lack of infiltration.

The differential includes cellular leiomyoma. Diagnosis may be aided by immunostaining; endometrial stromal nodules are positive for CD10; leiomyomas are positive for caldesmon and desmin (and sometimes CD10).

Low-grade endometrial stromal sarcoma[edit source | edit]

Low-grade endometrial stromal sarcoma consists of cells resembling normal proliferative phase endometrium, but with infiltration or vascular invasion. These behave more aggressively, sometimes metastasizing, with cancer stage the best predictor of survival. The cells express estrogen/progesterone-receptors.

Undifferentiated uterine sarcoma[edit source | edit]

Endometrial Stromal Sarcoma, High-Grade

Undifferentiated uterine sarcoma, or undifferentiated (high-grade) endometrial stromal sarcoma, does not resemble normal endometrial stroma and behaves much more aggressively, frequently metastasizing. The differential includes leukemia, lymphoma, high-grade carcinoma, carcinosarcoma, and differentiated pure sarcomas.

Cytologic and genetic features[edit source | edit]

A recurrent chromosomal translocation, t(7;17)(p15;q21), occurs in endometrial stromal sarcoma. This translocation leads to the fusion of two polycomb group genes, JAZF1 and JJAZ1, with production of a fusion transcript with anti-apoptotic properties. Interestingly, even normal endometrial stroma cells express the fusion gene, derived not by translocation, but by the "stitching" together of m-RNAs. Thus, it appears that a pro-survival gene in the normal endometrium is somehow subverted to become pro-neoplastic.^[3]

References[edit source | edit]

^ Sternberg's Diagnostic Surgical Pathology, 5th edition, p. 2242-2245.
^ Kumar V, Abbas A, Fausto N, Aster J (2010). Robbins and Cotran Pathologic Basis of Disease. 8th edition. Philadelphia: Elsevier Saunders
^ Li H et al (2009). "Gene fusion and RNA trans-splicing in normal and neoplastic cells". Cell Cycle.

UpToDate Contents

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1. 子宮内膜間質肉腫および子宮腺肉腫の分類および治療 classification and treatment of endometrial stromal sarcoma and uterine adenosarcoma
2. 子宮肉腫：分類、臨床症状、および診断 uterine sarcoma classification clinical manifestations and diagnosis
3. 子宮筋腫と子宮肉腫の識別 differentiating uterine leiomyomas fibroids from uterine sarcomas
4. 子宮平滑筋腫（子宮筋腫）の変異型 variants of uterine leiomyomas fibroids
5. 子宮平滑筋肉腫の治療および予後 treatment and prognosis of uterine leiomyosarcoma

English Journal

Immunohistochemical analysis for therapeutic targets and prognostic markers in low-grade endometrial stromal sarcoma.

Park JY, Kim KR, Nam JH.SourceDepartments of *Obstetrics and Gynecology, and †Pathology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society.Int J Gynecol Cancer.2013 Jan;23(1):81-9. doi: 10.1097/IGC.0b013e3182738361.
OBJECTIVE: To investigate potential therapeutic targets and prognostic markers for low-grade endometrial stromal sarcoma (LGESS).MATERIALS AND METHODS: Thirty-nine patients with LGESS were included in this study. Using tissue microarrays, the immunohistochemical expression levels of 5 therapeutic ta
PMID 23221606

Low-grade endometrial stromal sarcoma developing in a postmenopausal woman under toremifene treatment for breast cancer.

Kashiyama T, Oda K, Kawana K, Arimoto T, Kanetaka Y, Takazawa Y, Maeda D, Nakagawa S, Yano T, Kozuma S.SourceDepartments of Obstetrics and Gynecology Pathology, The University of Tokyo, Tokyo, Japan.
The journal of obstetrics and gynaecology research.J Obstet Gynaecol Res.2013 Jan;39(1):424-9. doi: 10.1111/j.1447-0756.2012.01915.x. Epub 2012 Jun 13.
Low-grade endometrial stromal sarcoma (ESS) is a rare neoplasm that is generally estrogen-receptor- and progesterone-receptor-positive and develops in premenopausal women. Although tamoxifen treatment is associated with an increased risk of ESS, the effect of other selective estrogen receptor modula
PMID 22690656

Japanese Journal

術後病理診断により粘液変性をきたした低悪性度子宮内膜間質肉腫と診断した1例

神奈川産科婦人科学会誌 = Kanagawa journal of obstetrics and gynecology : official journal, Kanagawa Society of Obstetrics and Gynecology 52(1), 91-94, 2015-09
NAID 40020624104

ISP-8-3 Retrospective analysis of 65 cases with endometrial stromal sarcoma, leiomyosarcoma and carcinosarcoma in CMC, Korea, 1990-2013(Group 8 Oncology 8,IS Poster,International Session)

日本産科婦人科學會雜誌 67(2), 1023, 2015-02-01
NAID 110009942135

Related Pictures

Pathology Outlines - Endometrial stromal sarcoma Endometrial stromal sarcoma - Wikipedia 2.1.1.6uterinecorpus - gracemedicalschool File:Endometrial stromal sarcoma (3) low-grade.jpg - Wikimedia Commons Sarcoma, Endometrial Stromal; Endometrial Stromal Sarcoma