卵巢原发甲状腺肿类癌的临床病理分析

目的:探讨卵巢原发甲状腺肿类癌的临床病理特征.方法:观察和分析2例卵巢原发甲状腺肿类癌病例的病理组织学及免疫表型的特点,并复习相关文献进行讨论.结果:例1卵巢类癌伴有成熟性囊性畸胎瘤成分,例2为单纯甲状腺肿类癌,类癌成分呈岛状与小梁状生长,甲状腺滤泡成分与类癌相互混杂.类癌的细胞比较一致,胞浆嗜酸性,染色质均匀,核分裂象少见.免疫组化2例类癌成分CK(+),CK19(+),CD56(+),NSE(+),Syn(+),TTF-1和TG散在阳性,甲状腺成分TTF-1(+)、TG(+).卵巢甲状腺肿类癌应与甲状腺癌鉴别,甲状腺癌的肿瘤细胞有高分裂活性,没有神经内分泌分化,细胞岛状或梁状分布不明显.结论:卵巢甲状腺肿类癌是罕见的低度恶性肿瘤,预后较好,病理形态学观察和免疫组化染色有助于明确诊断.

Primary strumal carcinoid of the ovary:A clinicopathological analysis

Objective:To study the clinicopathological features of primary strumal carcinoid of the ovary.Methods:The primary strumal carcinoid of the ovary were analyzed by gross morphology,microscopic appearence and immunohistochemical stains,the related literatures were reviewed.Results:The frist case showed pathology of strumal carcinod associated with mature cystic teratoma.The second case confirmed the diagnosis of pure strumal carcinoid of the ovary.On light microscopy,the carcinoid cells was arranged into trabecular or insular structure,intimately admixed with thyroid follicles.The tumor cells showed uniform with eosinophilic cytoplasm,fine nuclei chromatin and rare mitosis.Immunohistochemically,strumal carcinoid cells were positive for CK,CK19,CD56,NSE,Syn,and were scattered positive for TTF-1,TG.While the thyroid follicles were strong positive for TTF-1,TG.It was need to distinguished from thyroid carcinoma which indicated high mitotic activity,without neuroendocrine differentiation,the trabecular or insular structure of cells not obvious.Conclusion:The ovarian strumal carcinoid were a rare low-grade malignant tumor with a markedly better prognosis and clinical outcome.The diagnosis of ovarian strumal carcinoid can be established on histopathologic,immunohistochemical studies.