卵巢恶性Brenner瘤2例并文献复习

发布时间：2018-04-21 05:44

本文选题：卵巢肿瘤 + Brenner瘤　；参考：《临床与实验病理学杂志》2015年01期

【摘要】：目的探讨卵巢恶性Brenner瘤(malignant Brenner tumor,MBT)的临床病理学特征、诊断及鉴别诊断。方法回顾性分析2例卵巢MBT的临床病理学特征,并复习相关文献。结果患者年龄分别为63、72岁,临床主要表现为腹痛和盆腔包块,肿块均位于右侧卵巢,呈囊实性,体积较大。镜下见实性区上皮巢大小不一、层次增多,细胞具有轻度异型性,与低级别尿路上皮癌相似,部分区域细胞巢排列紧密,细胞异型性大,可见明显间质浸润;囊性区囊壁内衬上皮细胞,可出现明显黏液上皮化生。免疫表型:CKpan、CK7、WT1、PAX-8均弥漫阳性;CK20、p63、ER、PR、CA125、p53及Inhibin-α均阴性;肿瘤间质浸润区细胞核Ki-67增殖指数约90%。结论卵巢MBT是一种罕见的卵巢上皮性肿瘤,预后较差,需与卵巢原发或转移性移行细胞癌、交界性Brenner瘤及卵巢黏液性肿瘤鉴别,确诊主要依据组织病理学特征及免疫表型。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of malignant Brenner tumor of ovary. Methods the clinicopathological features of 2 cases of ovarian MBT were retrospectively analyzed and the related literatures were reviewed. Results the age of the patients was 63 ~ 72 years old. The main clinical manifestations were abdominal pain and pelvic mass. The masses were located in the right ovary and were cystic and solid. Under the microscope, the epithelial nests of solid areas varied in size, increased in layers, and the cells had mild heterogeneity, which were similar to those of low grade urothelial carcinoma. The nests of some regions were arranged closely and the cells had large heterogeneity, and obvious interstitial infiltration could be seen. Epithelial cells lining the cystic wall of the cystic area can be seen on mucous metaplasia. The proliferative index of nuclear Ki-67 in the interstitial area of the tumor was about 90%. The immunophenotype of CK20 p63ERP PRCA125, p53 and Inhibin- 伪 were all negative, and the proliferative index of nuclear Ki-67 in the interstitial area of tumor was about 90%. Conclusion Ovarian MBT is a rare epithelial ovarian tumor with poor prognosis. It should be distinguished from ovarian primary or metastatic transitional cell carcinoma, borderline Brenner tumor and ovarian mucinous tumor. The diagnosis is mainly based on histopathological features and immunophenotype.
【作者单位】：浙江省海宁市中医院妇产科;
【分类号】：R737.31

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