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目的探讨卵巢微囊性间质肿瘤(MCST)的临床病理特征及鉴别诊断。方法对1例卵巢MCST临床病理特征、免疫表型进行回顾性分析,并复习相关文献。结果患者女性,29岁。巨检:左侧卵巢结节状肿物,大小5.5 cm×5 cm×4.5 cm,表面不规则,似有包膜;切开见一囊腔,囊腔直径2.5 cm,内有咖啡色液体,其余切面实性,灰白、灰红色,质中。镜检:肿瘤细胞呈片巢状分布,多数细胞巢内见大小不等的囊腔,圆形或融合成不规则形,囊腔空亮,部分内含稀薄淡粉或淡蓝色分泌物,囊腔周围细胞呈圆形、卵圆形或短梭形,胞质红染,核大小较一致,无明显异型性,染色质细腻,未见核分裂。部分区域细胞成片,无微囊形成。肿瘤细胞巢之间有大片黏液样或玻璃样变区,可见灶性出血。局部肿瘤细胞呈腺泡状排列,胞质透明,核圆形居中,间质有丰富纤细的毛细血管。免疫组化:vimentin、CD10、β-catenin和WT-1(+),desmin、SMA、α-inhibin、CD99、S-100、CKpan、EMA、calretinin、CD56、Cg A和Syn均(-);Ki-67增殖指数3%。结论卵巢微囊性间质肿瘤是一类独特的肿瘤,其组织起源还不清楚,生物学行为倾向良性。
Objective To investigate the clinicopathological features and differential diagnosis of ovarian microcapsules of interstitial tumors (MCST). Methods A case of ovarian MCST clinicopathological features, immunophenotype were retrospectively analyzed, and review the relevant literature. Results Female patient, 29 years old. Macroscopic examination: the left ovarian nodular tumor, the size of 5.5 cm × 5 cm × 4.5 cm, the surface irregular, it seems enveloped; see a cyst incision, cyst diameter 2.5 cm, with a brown liquid, the rest of the liquid Section solid, gray, gray-red, quality. Microscopic examination: The tumor cells were nested in nests. Most of the nests in the nests of the cells were seeded with cysts of different sizes, rounded or fused into an irregular shape. The cysts were empty and some contained thin pale pink or light blue secretions. Cysts around the cysts were round, oval or short fusiform, cytoplasmic red dye, nuclear size more consistent, no significant atypia, chromatin delicate, no nuclear fission. Part of the region into a film, no microcapsule formation. Between the nests of tumor cells has a large mucoid or vitreous area, showing focal hemorrhage. Local tumor cells were arranged in alveolar shape, cytoplasm transparent, round center nuclear, interstitial rich slender capillaries. The expressions of vimentin, CD10, β-catenin and WT-1 (+), desmin, SMA, α-inhibin, CD99, S-100, CKpan, EMA, calretinin, CD56, Ki-67 proliferation index of 3%. Conclusions Ovarian microcapsules of interstitial tumors are a kind of unique tumor, the origin of which is unclear and the biological behavior tends to be benign.