卵巢上皮样恶性间皮瘤4例临床病理分析

发布时间：2018-03-05 18:26

本文选题：卵巢肿瘤　切入点：恶性间皮瘤　出处：《临床与实验病理学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨卵巢上皮样恶性间皮瘤(malignant mesothelioma,MM)的临床病理学特征、免疫表型、诊断及鉴别诊断。方法回顾性分析4例卵巢上皮样MM的临床病理学、免疫表型特征,并复习相关文献。结果 4例均为女性,年龄分别为51、47、56和69岁,肿瘤沿着卵巢、子宫及阑尾表面生长,同时累犯网膜组织;肿瘤细胞呈乳头状、腺样及实性结构,乳头的轴心透明变性,肿瘤细胞大小一致,部分胞质透亮,部分嗜酸,部分胞膜清楚,核分裂象易见,并见病理性核分裂。免疫表型:肿瘤细胞Calretinin、CK5/6、WT1、D2-40等均阳性,Ber-EP4、CEA、CK20等均阴性。2例分别于术后2.5、4个月死亡,2例术后随访8.5、9个月,仍处治疗中。结论卵巢上皮样MM为罕见肿瘤,恶性度高,生存率低,预后差,临床表现和组织学形态易与卵巢癌混淆,术前及冷冻病理诊断误诊率高,免疫表型有助于两者的鉴别。
[Abstract]:Objective to investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of malignant mesothelioma of ovary. Results all the 4 cases were female, aged 51, 47 and 69 years, respectively. The tumor grew along the ovary, uterus and appendicium, and involved in omentum tissue, and the tumor cells were papillary, glandular and solid, and the tumor cells showed papillary, glandular and solid structures. The papilla is axally hyaline denatured, the tumor cell size is uniform, some cytoplasm is bright, part is eosinophilic, some cell membrane is clear, the mitotic image is easy to see. Pathological mitosis was also seen. Immunophenotype: the tumor cells were all negative for Ber-EP4CEACEACK20 et al. 5 / 6 + WT1T D2-40 et al. 2 cases died 2.5 and 4 months after operation, 2 cases were followed up for 8. 5 and 9 months, and were still under treatment. Conclusion Ovarian epithelioid MM is a rare tumor with high malignancy. The survival rate was low, the prognosis was poor, the clinical manifestation and histological morphology were easily confused with ovarian cancer, the misdiagnosis rate of preoperative and frozen pathological diagnosis was high, and the immunophenotype was helpful to differentiate the two.
【作者单位】：浙江省宁波市临床病理诊断中心;
【基金】：宁波市医学科技计划项目(2014A19)
【分类号】：R737.31

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