摘要
目的探讨卵巢原发性小细胞癌(肺型)的临床病理特点、免疫表型及鉴别诊断,以及与同时发生的输卵管腺癌的内在联系。方法对1例卵巢原发性小细胞癌(肺型)并输卵管腺癌患者通过其组织病理形态及免疫组化染色观察,结合相关文献进行分析。结果该例患者为老年女性,57岁,临床表现为阴道流血、进行性腹胀。手术中见肿瘤位于右侧卵巢。大体肿块包膜完整,表面光滑,切开呈蜂房状或海绵样,见多个小的腔隙,质软。光镜下肿瘤细胞大小较为一致,瘤细胞呈弥散性、巢片状、岛状及梁状排列。细胞核呈圆形或椭圆形,核仁不明显,胞质较少,部分呈嗜酸性,有小片状坏死,核分裂象多见。肿瘤细胞侵入同侧输卵管壁内,输卵管腔内及管壁肌层内见中分化腺癌组织。免疫组化:卵巢肿瘤细胞弥散阳性表达CgA、CD56、Syn、NSE、Ck-pan、EMA;灶性阳性表达CK20、CK7;不表达CD99、vim、S-100、TTF-1、α-inhibin、CA125。结论卵巢原发性小细胞癌(肺型)是一种组织起源不明的罕见的高度恶性肿瘤,预后差,多数患者在1年内死亡,手术后辅以化疗及放疗可以延长生存时间。本例患者同时发生的输卵管腺癌为一种重复癌。
Objective To investigate the clinic pathologic features,immunophenotype and differential diagnosis of primary ovarian small cell carcinoma（pulmonary-type）and the relationship between primary ovarian small cell carcinoma and fallopian tube carcinoma which occurred simultaneously. Methods A case of primary small cell carcinoma of the ovary（pulmonary-type）complicated with adenocarcinoma of the fallopian tube were observed by the histopathology and immunohistochemistry and the related literature were reviewed. Results The specimen came from a57-year-old female whose clinical manifestations were vaginal bleeding and progressive abdominal distension. The tumor was located in the right ovary in the course of surgery. The majority of the tumor was encapsulated intact and the surface was smooth,and the tumor showed as honeycomb-shaped incision or sponge-liked and a number of small sofe cavities could be seen. The tumor cells were observed consistent in size and diffuse,nested sheet,island and beam-like in arrangement under light microscope. The nuclei were round or oval,and the nucleolus was not apparent,while part of the cytoplasm was eosinophilic,with small pieces necrosis,mitotic figure were common. Tumor cells invade in the ipsilateral fallopian tube wall,and cavity and adenocarcinoma was found in fallopian tube lumen as well as muscular wall. Immunohistochemistry：Ovarian tumor cells showed diffuse positive expression of Cga,CD56,Syn,NSE,Ckpan,EMA;focal positive expression of CK20,CK7;negative expression of CD99,VIM,S-100,TTF-1,α-inhibin,CA125. Conclusion Ovarian small cell carcinoma（pulmonary-type）is highly malignant tumor with poor prognosis,most patient die within a year. Chemotherapy and radiotherapy are supplemented after surgery can extend survival time.Conclusion The rare highly malignant primary ovarian small cell carcinoma（pulmonary-type）is a tissue of unknown origin with poor prognosis. The case which complicated with adenocarcinoma of the fallopian tube is a kind of repeat carcinoma.
出处
《基层医学论坛》
2014年第25期3393-3395,F0002,共4页
The Medical Forum
关键词
卵巢
原发性肺型小细胞癌
输卵管腺癌
免疫组化
鉴别诊断
Ovary Primary
Pulmonary-type small
cell carcinoma
Immunohistochemistry
Differential diagnosis
