卵巢硬化性间质瘤13例临床病理分析

发布时间：2018-05-04 04:30

本文选题：卵巢硬化性间质瘤 + 性索间质肿瘤　；参考：《四川大学学报(医学版)》2015年01期

【摘要】：目的分析卵巢硬化性间质瘤临床病理特点,探讨其诊断及鉴别诊断要点。方法回顾性分析我院2004年6月至2013年8月13例卵巢硬化性间质瘤患者的临床资料,对肿瘤进行组织形态观察和免疫组织化学染色结果研究。结果 13例患者发病年龄为4~73岁,平均年龄30.72岁。临床表现为月经周期紊乱5例,其中1例伴有不孕,盆腹腔包块4例,绝经后阴道不规则流血3例,性早熟1例。本组病例肿瘤均为单侧发生,左侧5例,右侧8例,肿瘤合并子宫腺肌症2例、子宫平滑肌瘤3例、同时合并子宫平滑肌瘤和子宫内膜宫内膜样腺癌2例。8例患者行肿瘤标志物检测,糖类抗原19-9(CA19-9)及糖类抗原125(CA125)各有1例略高于正常值;5例患者行性激素检测,其中3例性激素水平紊乱。镜下病理组织学特点为典型的假小叶结构,小叶内可见上皮样细胞、短梭形细胞及特征性的印戒样瘤细胞;免疫组化结果显示肿瘤细胞Calretinin弥漫阳性(13/13),α-inhibin阳性(13/13),Vimentin弥漫阳性(13/13),Actin弥漫阳性(13/13),SMA弥漫阳性(13/13),Desmin阳性(11/13);CEA、P-CK均阴性;空泡/印戒样细胞苏丹Ⅲ灶性(+)、PAS(-)。网状纤维染色结果显示肿瘤细胞被网状纤维围绕。结论卵巢硬化性间质瘤好发于20~30岁女性,在诊断上要与卵巢Krukenberg瘤及卵巢其它间叶源性肿瘤相鉴别,治疗采用手术切除,术后预后好,多无复发。
[Abstract]:Objective to analyze the clinicopathological features of ovarian sclerosing stromal tumors (OIST) and to discuss the diagnosis and differential diagnosis. Methods the clinical data of 13 patients with ovarian sclerosing stromal tumors from June 2004 to August 2013 were retrospectively analyzed. Results the onset age of 13 patients was 4 to 73 years old, with an average age of 30.72 years. The clinical manifestations were menstrual cycle disorder in 5 cases, including 1 case with infertility, 4 cases with pelvic and abdominal mass, 3 cases with irregular postmenopausal vaginal bleeding, 1 case with precocious puberty. All cases were unilateral, left 5 cases, right 8 cases, tumor with uterine adenomyosis 2 cases, uterine leiomyoma 3 cases. Tumor markers were detected in 2 cases of uterine leiomyoma and endometrial adenocarcinoma. One case of carbohydrate antigen 19-9 CA19-9) and one case of carbohydrate antigen 125 + CA125) were examined for sex hormone. Three of them had disorder of sex hormone level. The histopathological features were typical pseudolobular structure, epithelioid cells, short fusiform cells and characteristic signet-ring tumor cells in the lobules. The results of immunohistochemical staining showed that Calretinin was diffusely positive (13 / 13), 伪 -hibin (13 / 13 / 13) positive and Actin diffuse positive (13 / 13). The staining of reticular fibers showed that tumor cells were surrounded by reticular fibers. Conclusion Ovarian sclerosing stromal tumors (OIST) are common in women aged 20 to 30 years. The diagnosis should be differentiated from ovarian Krukenberg tumor and other ovarian mesenchymal tumors. Surgical resection is used to treat ovarian sclerosing stromal tumors with good prognosis and no recurrence.
【作者单位】：四川大学华西第二医院病理科;
【分类号】：R737.31

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