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目的探讨卵巢高钙血症型小细胞癌(OSCCHT)的临床特点、组织学特征及鉴别诊断。方法采用免疫组化En Vision两步法对1例卵巢高钙血症型小细胞癌组织进行染色,并结合临床资料分析其形态学特征及免疫表型,同时复习相关文献。结果镜下见肿瘤细胞弥漫成片或呈岛状、梁状和条索状分布,部分形成滤泡样腔隙,内含嗜酸性液体,核分裂象常见。免疫组化:vimentin、EMA、CD99、CK(AE1/AE3)、Syn和CD56均(+),Ki-67增殖指数为60%,α-inhibin、TTF-1、Td T和CD45均(-)。结论 OSCCHT是一种高度恶性肿瘤。鉴别诊断包括幼年型颗粒细胞瘤、卵巢肺型小细胞癌、转移性小细胞癌、卵巢原发性类癌、原始神经外胚层肿瘤、无性细胞瘤等。该病以手术治疗为主,辅以多药物联合化疗及放疗。
Objective To investigate the clinical features, histological features and differential diagnosis of ovarian hypercalcemic small cell carcinoma (OSCCHT). Methods One case of ovarian hypercalcemia type small cell carcinoma was stained with immunohistochemical En Vision method. The morphological characteristics and immunophenotype were analyzed according to the clinical data. At the same time, the related literatures were reviewed. Results Microscopically, the tumor cells diffuse into a sheet or island shape, beam-like and cord-like distribution, the formation of part of the follicular-like cavity, containing eosinophilic fluid, mitotic common. The expressions of vimentin, EMA, CD99 and CK (AE1 / AE3), Syn and CD56 (+), Ki-67 proliferation index were 60% . Conclusion OSCCHT is a highly malignant tumor. Differential diagnosis includes juvenile granulosa cell carcinoma, ovarian small cell lung cancer, metastatic small cell carcinoma, primary carcinoid ovary, primitive neuroectodermal tumors, dysgerminoma and so on. The disease is mainly treated by surgery, supplemented by multi-drug combination chemotherapy and radiotherapy.