肾上腺皮质癌临床病理特征及其网状纤维染色的意义

发布时间：2018-05-19 23:39

  本文选题：肾上腺肿瘤 + 肾上腺皮质癌　； 参考：《临床与实验病理学杂志》2017年11期

【摘要】：目的探讨肾上腺皮质癌(adrenocortical carcinoma,ACC)的临床病理特征及其网状纤维染色意义。方法收集20例肾上腺皮质腺瘤(adrenocortical adenoma,ACA)和16例ACC,分析两者的临床、影像学、病理特点、网状纤维染色,并复习相关文献。结果 ACA中位病程21个月,肿瘤最大中位直径2.6 cm;ACC中位病程5个月,肿瘤最大中位直径9.5 cm,9例诊断时已发生远处转移。ACA瘤细胞呈巢团状、粗梁状排列,胞质嗜酸或透明,核异型不明显,核分裂象罕见,无包膜、窦隙、静脉侵犯,出血、坏死、粗大胶原纤维少见。Weiss积分均≤2分,平均(0.85±0.81)分。ACC癌细胞呈巢团状、粗梁状、条索状或弥漫性排列,多数胞质嗜酸性,可见不同程度的核异型以及非典型核分裂,可见包膜、窦隙、静脉侵犯,出血、坏死、粗大胶原纤维易见。Weiss积分均≥3分,平均(5.2±1.3)分。免疫表型:ACA、ACC中vimentin、Syn、NSE、CK、CR、Melan-A、α-inhibin的表达比较差异无统计学意义(P0.05)。网状纤维染色:20例ACA网状纤维结构规则完整,未见断裂、塌陷、稀疏或消失;16例ACC网状纤维结构破坏,不同程度的断裂、塌陷、稀疏或消失,两者网状纤维结构破坏率比较差异有统计学意义(P0.01)。结论ACC的免疫表型缺乏特征性,直径增大、远处转移、粗大胶原纤维、网状纤维结构破坏对判断恶性特征具有重要意义。
[Abstract]:Objective to investigate the clinicopathological features and the significance of reticular fiber staining in adrenocortical carcinoma (ACCs). Methods 20 cases of adrenocortical adenoma ACAA and 16 cases of ACCs were collected. The clinical, imaging, pathological and reticular fiber staining were analyzed, and the related literatures were reviewed. Results the median course of ACA was 21 months, the median course of ACA was 2. 6 cm ~ (-1) and the median diameter of tumor was 9. 5 cm ~ (-1). Distant metastasis was found in 9 cases. The tumor cells were nestled, thick beam arranged, cytoplasmic acidophilic or transparent. There were no capsule, sinus space, venous invasion, hemorrhage, necrosis, coarse collagen fibers. Weiss score was 鈮，

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