卵巢富细胞纤维瘤24例临床病理分析

发布时间：2019-01-26 19:49

【摘要】：目的:探讨卵巢富细胞纤维瘤的临床与病理学特征。方法:收集2008年2月至2017年3月复旦大学附属妇产科医院诊治的24例卵巢富细胞纤维瘤患者的临床病理资料,观察肿瘤组织学特征、免疫表型,并进行随访。结果:24例患者年龄为17~70岁,平均46.5岁。临床症状包括卵巢肿块、下腹胀痛或合并胸腹水。2例患者术前伴CA125显著升高。卵巢富细胞纤维瘤发生于右侧卵巢、左侧卵巢、双侧卵巢分别为13、10、1例。镜下显示肿瘤细胞丰富、无明显异型性。3例患者的肿瘤细胞核分裂象活跃,核分裂象5~7个/10个高倍视野(high power fields,HPF),3例患者的肿瘤中含少量(少于10%)性索成分,4例见黄素化细胞。随访1~109个月,未见复发。结论:卵巢富细胞纤维瘤是纯间质肿瘤,可有核分裂象增多、伴有少量性索成分及黄素化。部分患者合并胸腹水及CA125升高,易误诊为恶性肿瘤。为避免误诊以影响临床诊断和治疗,认识该病具有重要的意义。
[Abstract]:Objective: to investigate the clinical and pathological features of ovarian rich-cell fibroma. Methods: the clinicopathological data of 24 patients with ovarian rich cell fibroma treated by Department of Obstetrics and Gynecology affiliated to Fudan University from February 2008 to March 2017 were collected and the histological features and immunophenotype of the tumor were observed and followed up. Results: the age of 24 patients was 1770 years (mean 46.5 years). The clinical symptoms included ovarian mass, lower abdominal distending pain or hydrothorax and ascites. 2 patients had significantly elevated CA125 before operation. Cell-rich fibroma of ovary occurred in right ovary, left ovary and bilateral ovary in 1 case. The results showed that there were plenty of tumor cells and no obvious heterogeneity. The mitotic nuclei of 3 patients were active, the mitotic images were 5 ~ 7 / 10 high-power field (high power fields,HPF), and the tumor of 3 patients contained a small amount (less than 10%) of sex cord components. Luteinized cells were seen in 4 cases. Follow-up for 1 ~ 109 months showed no recurrence. Conclusion: ovarian cell-rich fibroma is a pure interstitial tumor with increased mitotic appearance with a small amount of sex cord and luteinization. Some patients with ascites of pleural effusion and CA125 were easily misdiagnosed as malignant tumor. In order to avoid misdiagnosis to affect the clinical diagnosis and treatment, it is of great significance to recognize the disease.
【作者单位】：复旦大学附属妇产科医院病理科;
【分类号】：R737.31

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