卵巢粘液性囊性肿瘤伴实性附壁结节的病理诊断

本文通过卵巢粘液性囊腺癌伴肉瘤样附壁结节，卵巢粘液性囊腺癌伴局限性间变癌和卵巢癌肉瘤各１例的形态学和免疫组织化学研究，讨论其鉴别诊断。三种不同性质的肿瘤大体均以卵巢囊性肿瘤伴实性附壁结节的形式出现，组织学形态也十分相似。但肉瘤样附壁结节无浸润性边缘，核分裂数≤１０个／１０ＨＰＦ，免疫标记ＫＰ－１阳性。间变性癌有浸润性边缘，和囊肿上皮间有移行，间质胶原反应较明显，免疫标记ＥＭＡ或Ｃｙｔｏｋｅｒａｔｉｎ阳性。卵巢真正的肉瘤也有浸润性边缘，和上皮成分相互渗透，核分裂数＞１０个／１０ＨＰＦ，免疫标记ＫＰ－１阴性，但Ｖｉｍｅｎｔｉｎ阳性。

Pathologic diagnosis of three cases of ovarian mucinous cystic tumors with solid mural nodules

case with ovarian mucinous cystadenocarcinoma with sarcoma-like mural nodule,1 with ovarian mucinous cystadenocarcinoma with anaplastic carcinoma and 1 with ovarian carcinosarcoma were reported.Macroscopically,they were all cystic tumors with solid mural nodules.The microscopic findings of these tumors were also similar .But in sarcoma-like nodules,they were sharply demarcated,less than and equal to 10 mitotic figures were seen in 10 high power fields and KP-1 was positive in immunohistochemical stain.In anaplastic carcinoma,invasive borders were seen,collagenous reaction was obvious and EMA or cytokeratin stain was positive.In ovarian sarcoma,invasive borders were also present,sarcoma cells invading into the epithelial tissue,more than 10 mitotic figures were in 10 high power fields,KP-1 stain was negative,but vimentin stain was positvie.