目的探讨子宫平滑肌腺瘤样瘤的病理形态学特点、诊断及鉴别诊断。方法应用光镜观察及免疫组化方法对2例子宫平滑肌腺瘤样瘤进行临床病理分析,并复习文献。结果 2例子宫平滑肌腺瘤样瘤均发生在中年女性,临床与大体检查类似子宫平滑肌瘤,肿瘤境界清楚,镜下特点为大量平滑肌束间散在分布许多大小不等的腔隙;腔隙内衬扁平或立方细胞,可见刷状缘和线状桥连接的特征,瘤细胞核异型性小,无核分裂象。免疫组化:腺瘤样瘤细胞CK和MC(+),CD34(-);平滑肌瘤细胞SMA(+)。结论平滑肌腺瘤样瘤是一个具有明确形态学特征的腺瘤样瘤的变型,其病理形态学特点为瘤性增生的平滑肌束中散布腺瘤样瘤的成分,该肿瘤应与子宫平滑肌瘤、浸润性腺癌等肿瘤相鉴别。 Objective To investigate the pathomorphological features, diagnosis and differential diagnosis of uterine smooth muscle adenomatoid tumor. Methods The clinical and pathological analysis of 2 cases of uterine smooth muscle adenomatous tumor were observed by light microscopy and immunohistochemistry. The literature was reviewed. Results 2 cases of uterine smooth muscle adenoma-like tumor occurred in middle-aged women, clinical and general examination of similar uterine leiomyoma, clear tumor state, microscopic features of a large number of smooth muscle bundles scattered between the size of many lacunar; Lined with flat or cubic cells, showing the brush edge and the characteristics of linear bridge connections, tumor cell nuclear atypia, mitotic figure. Immunohistochemistry: adenoma-like cells CK and MC (+), CD34 (-); leiomyoma cells SMA (+). Conclusions Atypical adenomatoid tumor is a variant of adenoma-like tumor with definite morphological features. Its pathomorphological features are the components of adenoma-like tumor in smooth muscle bundles of neoplastic hyperplasia. The tumor should be associated with uterine leiomyomas , Invasive adenocarcinoma and other tumor phase identification.