睾丸肾上腺残余肿瘤的临床病理特点

发布时间：2018-03-05 12:22

本文选题：睾丸肿瘤　切入点：睾丸肾上腺残余肿瘤　出处：《中山大学学报(医学科学版)》2015年06期 　论文类型：期刊论文

【摘要】：【目的】睾丸肾上腺残余肿瘤(TART)是睾丸少见良性肿瘤,因其罕见常易误诊为睾丸间质细胞瘤等其他肿瘤,是临床诊断难点。本研究收集并总结了13例TART的病理临床特点,目的是提高对该病的认识和临床诊断水平。【方法】收集中山大学附属第一医院2009-2014年间13例确诊的TART病例,通过回顾影像学资料和病理组织学特点、免疫组化染色、结合临床症状预后分析,归纳TART的临床病理特点。【结果】13例TART患者均为男性,平均年龄12.15岁,临床均表现为肾上腺皮质综合症(CAH),双侧睾丸同时发病。B超检查显示双侧睾丸均为孤立性病灶,病变位于睾丸网或围绕睾丸纵隔生长。病变形态多样,边界清楚,无包膜,以低回声为主,部分病灶内血供丰富。肿瘤大小0.2~4 cm,平均1.1 cm。组织学检查显示睾丸肿瘤形态类似于肾上腺皮质,瘤细胞胞质丰富红染,核居中,可见小核仁,但核分裂像少见,未见病理性核分裂像。肿瘤与周围组织分界清,未见邻近组织和血管侵犯。免疫组化染色显示肿瘤细胞弥漫表达波形蛋白和抑制素a,但均不表达神经内分泌标记,Ki-67指数小于1%。13例患者均行手术完整剔除肿瘤,术后随访3月~6年,无肿瘤复发。【结论】TART常与CAH伴发,肿瘤具有肾上腺皮质特征。对CAH患者行睾丸超声检查有助于早期发现肿瘤,及时挽救睾丸功能。TART手术切除预后良好,无需术后辅助治疗。
[Abstract]:[objective] the residual tumor of testicular adrenal gland (TARTT) is a rare benign tumor of testis, which is often misdiagnosed as testicular stromal cell tumor and other tumors, which is difficult in clinical diagnosis. This study collected and summarized the pathological and clinical features of 13 cases of TART. Objective to improve the recognition and clinical diagnosis of the disease. [methods] 13 cases of TART diagnosed in the first affiliated Hospital of Sun Yat-sen University from 2009 to 2014 were collected. The clinicopathological features of TART were summarized. [results] all 13 patients with TART were male, with an average age of 12.15 years. The clinical manifestations were adrenocortical syndrome (CAH), the bilateral testis were at the same time. B-ultrasonography showed that the bilateral testis were solitary lesions, and the lesions were located in the testicular reticulum or around the testis mediastinum. The lesions were varied in shape, with clear boundary and no capsule. The tumor size was 0.2 ~ 4 cm, with an average of 1.1 cm. Histological examination showed that the shape of testicular tumor was similar to that of adrenal cortex, the cytoplasm of tumor cells was rich in red stain, the nucleus was in the middle, small nucleoli could be seen, but the mitosis was rare. No pathological mitosis was seen. The boundary between the tumor and the surrounding tissue was clear. There was no invasion of adjacent tissues and blood vessels. Immunohistochemical staining showed diffuse expression of vimentin and inhibin a in tumor cells, but no neuroendocrine marker Ki-67 was found in all of the 13 patients. Follow up from March to 6 years after operation, no tumor recurred. [conclusion] TART is often associated with CAH, and the tumor has adrenal cortical features. Testicular ultrasound examination in CAH patients is helpful for early detection of tumor, and timely rescue of testicular function. TART surgery has a good prognosis. There is no need for postoperative adjuvant treatment.
【作者单位】：中山大学附属第一医院病理科;中山大学附属第一医院超声科;中山大学附属第一医院转化医学中心;
【分类号】：R737.21

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