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目的探讨高分化乳头状间皮瘤(well differentiated papillary mesothelioma,WDPM)的临床病理学特征、鉴别诊断和预后。方法报告1例盆腔腹膜高分化乳头状间皮瘤的临床资料行HE及免疫组化染色,分析其临床病理学特征及免疫组化特点,并复习相关文献。结果患者在腹腔镜探查术中,偶然发现盆底壁层腹膜表面散在分布多个大小不等粟粒状结节。大体见灰白色结节二枚,米粒及黄豆大,切面灰白色。镜检示肿瘤组织呈乳头状,乳头表面被覆单层扁平或立方状上皮样细胞,被覆细胞无异型,乳头内具有粘液样的纤维血管轴心。免疫组化示乳头表面被覆的上皮样细胞CEA(-)、Calretinin(+)、mesothelin(+)、HBME-1(+)、ki-67(10%)。结论 WDPM是一种罕见的低度恶性潜能的间皮肿瘤,无特异的临床症状,多为手术中偶然发现,放化疗等辅助治疗使用与否目前尚有争论。
Objective To investigate the clinicopathological characteristics, differential diagnosis and prognosis of well differentiated papillary mesothelioma (WDPM). Methods One case of peritoneal peritoneal papillary mesothelioma was reported by HE and immunohistochemical staining. The clinicopathological characteristics and immunohistochemical characteristics were analyzed. Relevant literatures were reviewed. Results In laparoscopic exploration, patients occasionally found multiple peritoneal nodules distributed in the peritoneal surface of the pelvic floor. See generally two white nodules, rice and soybeans, cut white. Microscopically, the tumor tissue was papillary. The papillary surface was covered with flat or cuboidal epithelial cells in monolayer. The covered cells showed no abnormality. The nipple had a mucoid fiber axis. Immunohistochemistry showed CEA (-), Calretinin (+), mesothelin (+), HBME-1 (+) and ki-67 (10%) of epithelial- Conclusion WDPM is a rare low-grade malignant mesothelioma. There are no specific clinical symptoms, such as occasional discovery of surgery, adjuvant chemotherapy and radiotherapy and chemotherapy or not. There is still controversy.