卵巢支持-间质细胞瘤6例临床病理分析

目的:探讨卵巢支持-间质细胞瘤（sertoli-leydig cell tumor，SLCT）的大体及显微镜下特点，免疫组化表达及临床特征，诊断、鉴别诊断要点及预后因素分析。方法:收集6例SLCTs标本观察大体及镜下特征，分析临床病理特点，行免疫组化方法检查及文献复习。结果:卵巢支持-间质细胞瘤罕见，可出现男性化或去女性化表现，5例发生于一侧卵巢，1例发生于双侧卵巢，2例远处转移，镜下Sertoli 细胞排列呈管状、条索状、岛状，细胞核圆形或卵圆形，胞质淡染或透明，Leydig细胞单个或成簇出现于间质内，核小，具有丰富的嗜酸性胞质。两种细胞逐渐过渡移行。随访10~96 个月，3例死亡，3例存活。免疫组化α-inhibin、CD99、CR、CD10、CyclinD1及β-catenin阳性。结论:SLCT形态复杂，诊断困难，预后与分化程度、临床分期有关。

Clinical and pathologic analysis of six cases of sertoli-leydig cell tumor in ovary

Objective:To observe the gross and microscopic features and clinicopathological and immunohistochemistry characteristics of sertoli-Leydig cell tumour，and to explore the diagnosis，differential diagnosis and prognosis of sertoli-leydig cell tumour(SLCTs).Methods:6 cases of SLCTs were examined by light microscopy and immunochemistry.The features of clinicopathological and summarizing immunohistochemical features and literature review were analysed.Results:Ovarian sertoli-leydig cell tumors were rare and can be masculinized or de-feminized.Five cases located in one ovary，one in bilateral and two cases were with distant metastasis.The tumors were consisted of sertoli cells and gonad interstitial cells.Sertoli cell had spherical or oval nucleus，some of short rod nucleus，and had light coloured or transparent cytoplasm.Ledig cells appeared in the interstitial tissue singly or in clusters，with small nuclei and abundant eosinophlilc cytoplasm.Two kinds of cells gradually transformed.With a follow-up of 10~96 months，three patients were dead and three were alive.The immunohistochemistry of α-inhibin，CD99，CR，CD10，CyclinD1 and β-catenin were positive.Conclusion:The morphology of SLCT is complex and difficult to diagnose.The prognosis is related to tumor differentiation and clinical stage.