卵巢恶性苗勒管混合瘤6例临床病理分析

目的探讨卵巢恶性苗勒管混合瘤的临床病理特点及鉴别诊断。方法复习6例卵巢恶性苗勒管混合瘤患者的临床资料,行常规石蜡切片和免疫组化染色。结果恶性苗勒管混合瘤镜下肿瘤成分复杂,形态多样,由上皮和间叶两种成分构成,相互间有穿插及移行。免疫组化:腺上皮CK(+),间质成分vimentin(+);2例ER(+),1例PR(+);CD34和desmin(-)。结论卵巢恶性苗勒管混合瘤诊断主要依赖组织学形态,临床主要与不成熟畸胎瘤相鉴别。     

腹膜原发性腺癌8例临床病理特征及鉴别诊断

目的 探讨腹膜原发性腺癌的临床病理特征和鉴别诊断.方法 回顾性分析8例腹膜原发性腺癌的临床病理资料,对肿瘤进行光镜观察,并做免疫组化染色.结果 患者均为女性,平均年龄55.7岁,以腹胀、腹水为主要临床表现;组织学表现为浆液性乳头状腺癌7例,黏液腺癌1例.免疫组化:8例广谱CK、CK7、EMA和p53(+),7例CA125和CEA(+),CK20、vimentin和calretinin(+)各1例.结论 腹膜原发性腺癌被认为是起源于第二苗勒管系统的恶性肿瘤,其组织病理类型与卵巢癌相似,因此诊断前必须证实双侧卵巢、输卵管及子宫无同类型肿瘤.免疫组化染色对于腹膜原发性腺癌与卵巢癌的鉴别无意义,但对除外胃肠道转移癌和恶性间皮瘤有帮助.     

卵巢及腹膜肿瘤组织学分类(2003)

1表面上皮-间质肿瘤 1．1 浆液性肿瘤；恶性 腺癌；表面乳头状腺癌；腺癌纤维瘤(恶性腺纤维瘤)；交界性 乳头状囊性肿瘤；表面乳头状肿瘤；腺纤维瘤，囊腺纤维瘤     

膀胱原发性透明细胞腺癌临床病理观察

目的 分析膀胱原发性透明细胞腺癌的病理形态、免疫组化特点和鉴别诊断。方法 运用组织病理学、组织化学、免疫组化方法进行观察，并结合文献资料进行探讨。结果 瘤细胞呈实性片状、腺管状、灶性乳头状排列，细胞质丰富，透明；部分细胞胞质嗜酸性，呈鞋钉样。免疫组化显示AEI／AE3、CK7、EMA、p53强（＋），200个细胞中Ki-6730％-60％（＋）（平均38％阳性）；CA125散在（＋）、CK20、AFP、CEA、Cga、Vim（-）。组织化学PAS（＋），阿尔辛蓝显示腺腔及囊腔内酸性黏液。结论 膀胱原发性透明细胞癌是膀胱癌中的一种罕见的特殊类型，多来源于化生的移行上皮癌变、也可来源于苗勒管上皮及肾源性腺瘤恶变。     

卵巢肿瘤组织分型

1　表面上皮—间质肿瘤1.1　浆液性肿瘤1.1.1　良性1.1.1.1　囊腺瘤 ;乳头状囊腺瘤1.1.1.2　表面乳头状瘤1.1.1.3　腺纤维瘤 ;囊腺纤维瘤1.1.2　交界恶性 (低度恶性潜能 )1.1.2 .1　囊性肿瘤 ;乳头状囊性肿瘤1.1.2 .2　表面乳头状肿瘤1.1.2 .3　腺纤维瘤 ;囊腺纤维瘤1.1.3　恶性1.1.3.1　腺癌　 (1)乳头状腺癌 ;(2 )乳头状囊腺癌1.1.3.2　表面乳头状腺癌1.1.3.3　腺癌纤维瘤 ;囊腺癌纤维瘤 (恶性腺纤维瘤 ;囊腺纤维瘤 )1.2　黏液性肿瘤 (包括子宫颈管内膜样和肠型 )1.2 .1　良性1.2 .1.1　囊腺瘤1.2 .1.2　腺纤维瘤 ;囊腺纤维瘤1.2 .2　交界…     

阴道良性混合瘤临床病理观察

目的 探讨阴道良性混合瘤的临床病理学特点及诊断要点.方法 对1例阴道良性混合瘤进行临床资料、病理学形态及免疫组化观察,并结合文献探讨其诊断及鉴别诊断.结果 患者女性,40岁.因子宫多发性平滑肌瘤、子宫腺肌症行经腹全子宫切除术,术中发现阴道壁接近处女膜缘处有一直径2 cm肿物,遂行剥除.镜下可见肿瘤组织呈腺样及小团巢状分布,局部呈黏液乳头状,部分区域细胞呈梭形,核大小较一致,偶见核分裂;肿瘤无明显包膜,与周围组织有界限.免疫组化:瘤细胞CD34、bcl-2、CD99、ER、PR、CD10、CK7和AE1/AE3(+),CK8/18弥漫(+);鳞状上皮34βE12和CK5/6(+),SMA灶状(+);Ki-67增殖指数为3％,p63、GFAP、CK20、CgA、Her-2、S-100和CA125均(-).病理诊断为阴道良性混合瘤.术后随访半年无复发.结论 阴道良性混合瘤是由间叶性成分和鳞状上皮或腺上皮构成的混合性良性肿瘤,罕见,易与其他肿瘤混淆导致误诊.     

原发性腹膜砂砾体癌一例

目的探讨原发性腹膜砂砾体癌的临床病理特点、诊断及意义。方法通过光镜和免疫组织化学方法对1例原发性腹膜砂砾体癌组织标本进行观察。结果原发性腹膜砂砾体癌细胞形态及组织结构单一,较多砂砾体存在于肿瘤组织内。免疫组化染色CK（＋）,vimentin（-）,CA125（＋）,CK20（-）,CK7（＋）。结论原发性腹膜砂砾体癌十分罕见,肿瘤内大量砂砾体提示其可能具有较为良好的预后。     

子宫恶性苗勒管混合瘤的诊治

目的对子宫恶性苗勒管混合瘤诊断及治疗作一分析。方法回顾性分析我院1999年1月至2009年7月收治的3例子宫恶性苗勒管混合瘤的临床资料。结果子宫恶性苗勒管混合瘤缺乏特异性的临床表现,易漏诊及误诊,病理分期及组织学类型与预后密切相关。结论手术切除对治疗子宫恶性苗勒管混合瘤十分重要,术后辅以放、化疗对提高生存率有帮助。     

腹膜假黏液瘤

腹膜假黏液瘤作为临床的特定疾病名称已沿用多年。但有关其性质、来源一直存有争议。目前大多数观点认为，腹膜假黏液瘤不是一个严格的组织病理学概念。其来源大多数为阑尾的肿瘤、黏液腺瘤、交界性黏液腺瘤或腺癌。诊断时应尽量检查阑尾，以确定是否是来源于阑尾。形态上腹膜假黏液瘤可分为腹膜黏液癌病和播散性腹膜腺黏液病。前者预后差。     

鼻部多形性腺瘤

多形性腺瘤(pleomorphic adenoma)又称混合瘤(mixedtumor)，主要发生于涎腺：在涎腺中腮腺最多见，其次为颌下腺、舌下腺．亦可见于口腔内的小涎腺。Eveson等曾报道多形性腺瘤占腮腺肿瘤的63．3％，占下颌下腺肿瘤的59．5％，占小涎腺肿瘤的42．9％，发生于鼻部的多形性腺瘤临床上很少见，约占鼻腔鼻窦良性肿瘤的1．71％.     

Papillary adenofibroma of the cervix: a case report.

Adenofibroma is an extremely rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group. It typically affects the endometrium, but may occur in the cervix or in an extrauterine location. Preoperative diagnosis of this tumor is usually difficult. We describe the case of a 55-year-old woman with papillary cervical adenofibroma, which appeared as a cervical mass containing multiple cystic components on transvaginal ultrasound. This lesion appears to be clinically and histologically benign but must be differentiated from malignant lesions of the uterus, particularly from adenosarcoma, which can be suggestive of adenofibroma. Accurate diagnosis of these benign tumors permits appropriate counseling of patients.     

Adenofibroma of the endometrium after tamoxifen therapy for breast cancer: MR findings

We report a case of adenofibroma of the endometrium in a 69-year-old woman. This patient was receiving tamoxifen therapy after surgery for breast cancer. Magnetic resonance imaging showed an intracavitary mass containing multiple cystic components. We suggest adenofibroma as a possible diagnosis in cases of uterine masses with multiple cystic components and no clinical evidence of malignancy.     

Sonographic appearance of Krukenberg tumor from gastric carcinoma

Sonographic findings in 16 cases of Krukenberg tumor from gastric carcinoma were analyzed. The patients' ages ranged from 25 to 52 years (mean 42 years). The tumor involved both ovaries in 14 patients with asymmetrical masses in 9 of 14 cases. Ascites was noted in 15 cases. Echogenicity of the tumor varied from solid to predominantly cystic: solid in 8, mixed in 6, and predominantly cystic in 2 cases. Solid masses tended to be smaller than mixed or cystic masses. The primary gastric carcinoma had been diagnosed before emergence of the tumors in only 7 cases. The findings suggest that in relatively young patients with ovarian mass, particularly bilateral tumors, careful evaluation for gastrointestinal tract involvement should be done.     

多排CT鉴别诊断肾脏混合性上皮间质肿瘤与囊性肾瘤

目的 探讨肾脏混合性上皮间质肿瘤(MESTK)与囊性肾瘤(CN)的多期螺旋CT表现特点,以期提高术前诊断及鉴别诊断的准确性.方法 采用盲法回顾性对比分析经手术病理证实的6例MESTK和6例CN患者的螺旋CT表现,并与病理结果进行对照.结果 MESTK和CN均表现为肾脏内单发的边缘规则多囊性肿块.其中MESTK Bosniak Ⅲ型5例,Bosniak Ⅳ型1例;6例CN均为Bosniak Ⅱ型.6例MESTK均为囊实性肿物,肿瘤内均可见数量不等的实性成分,间隔平均厚度为0.93 cm,而6例CN均表现为完全囊性病变,囊壁未见实性成分,间隔平均厚度为0.23 cm.增强扫描,MESTK的实性部分和CN的囊壁均表现为轻度或中度延迟强化.结论 多期螺旋CT扫描可为MESTK和CN的诊断提供客观依据.肿瘤有无实性成分是鉴别两者的重要CT征象.     

卵巢原发性恶性肿瘤的螺旋CT诊断

目的 探讨卵巢原发性恶性肿瘤的螺旋CT表现特点。方法 回顾性分析100例经手术病理证实为卵巢恶性肿瘤的螺旋CT资料并与手术病理对照分析。结果 ①上皮性肿瘤88例（88％），以囊实性为主，占79．5％，多有腹水和腹膜、网膜种植及淋巴结转移；②性索间质肿瘤5例（5％），均为单侧，以囊实性肿块为主，占80．0％；③生殖细胞肿瘤7例（7％），均为单侧，以实质性为主，占71．4％。结论 螺旋CT对卵巢原发性恶性肿瘤有很高的诊断价值。     

Sonographic findings of solid and papillary epithelial neoplasm of the pancreas.

OBJECTIVE: To evaluate the sonographic findings of solid and papillary epithelial neoplasm of the pancreas, a rare tumor occurring in young women. METHODS: The sonographic findings of 11 cases of pathologically proven solid and papillary epithelial neoplasm of the pancreas were retrospectively evaluated. RESULTS: In 6 cases (55%), combined cystic and solid portions of the masses were observed, whereas only solid-looking masses without anechoic cystic portions were seen in 4 cases (36%). One case (9%) had marginal calcification, consequently, the internal architecture was not evaluated by sonography. Internal echoes were seen in 3 of 6 cystic and solid masses. Septa were seen in 3 cases. Among 11 cases of solid and papillary epithelial neoplasm, tumor margins were well defined in 10, and tumor capsules were detected in 9 (echogenic in 7 and hypoechoic in 2). Calcifications were seen in 3 cases (27%). CONCLUSIONS: The characteristic sonographic findings of solid and papillary epithelial neoplasm were well-encapsulated, cystic, and solid masses, but sometimes the mass was seen as a pure solid-looking mass or had internal septations or calcifications.     

子宫恶性苗勒氏管混合瘤28例临床分析

目的通过28例子宫恶性苗勒氏管混合瘤的临床资料,探讨相关因素及适当的治疗方法.方法回顾性分析1972年1月～1997年12月我院收治的28例子宫恶性苗勒氏管混合瘤的临床资料.结果5年总生存率35.7%.癌肉瘤5年生存率41.7%,中胚叶混合瘤5年生存率31.3%(P＞0.05).Ⅰ、Ⅱ期患者5年生存率56.3%,明显高于Ⅲ、Ⅳ期的9.1%(P＜0.01).子宫体积大于妊娠10周者,5年生存率0%,小于10周者,5年生存率53.0%(P＜0.01).已绝经组5年生存率38 9%,高于未绝经组30%(P＞0.05).应用Cox模型比较术后加放疗或化疗对生存率的影响,放疗组明显高于化疗组,P＜0.01.表明化疗可提高患者生存率.结论子宫恶性苗勒氏管混合瘤生存率与手术病理分期、子宫大小有密切关系,与病理类型、是否绝经无明显关系,术后辅以放疗对提高生存率有帮助.     

卵巢囊性肿瘤的影像学分析

目的：分析卵巢囊性肿瘤的影像学特点,为临床提供可靠的诊断及治疗依据。方法回顾性分析45例经手术及病理证实的卵巢囊性肿瘤的C T或M RI影像资料。纳入标准为病灶囊性成分所占比例大于70％,肿瘤最大径超过5 cm。所有病例均行平扫及增强C T或M RI检查。结果45例中包括卵巢囊腺瘤16例、囊腺癌6例、腺癌5例、腺纤维瘤1例、畸胎瘤2例、囊肿4例、子宫内膜异位囊肿2例、输卵管系膜囊肿2例及输卵管卵巢囊肿7例。结论影像学检查对卵巢囊性肿瘤的定位、定性诊断和鉴别诊断具有一定的临床意义,明确诊断仍需要结合术后病理结果。     

腹膜低度恶性囊性间皮瘤的病理诊断和鉴别诊断

目的 分析腹膜低度恶性囊性间皮瘤的病理形态学、诊断及鉴别诊断。。方法 报道18例腹膜低度恶性囊性间瘤,从病理大体及光镜组织化学等方面进行观察。结果 18例腹膜低度恶性囊性间皮瘤,以中青年女性居多。肿瘤呈单发囊性或多发囊性肿块以及弥漫囊状小结节累及盆腔或腹腔腹膜。肿瘤微囊衬以单层立方状或扁平状细胞,瘤细胞有轻度异型性,其中1例瘤组织转变的恶性间皮瘤,3例瘤组织局灶性浸润肠壁深肌层,有7例肿瘤复发。结论 提出此病的病理诊断要点,还对腹膜低度恶性囊性间皮瘤与腹膜恶性间皮瘤、性淋巴管瘤、腹膜假性黏液瘤以及腺瘤以及腺瘤样瘤的鉴别诊断做了简要讨论。     

Peritoneal cavernous hemangiomatosis:A case report

BACKGROUND Cavernous hemangiomatosis in the liver and spleen has been reported, but it occurs less commonly in the peritoneum. Here we report a case of peritoneal cavernous hemangiomatosis and share some valuable information about this disease.CASE SUMMARY A 57-year-old Chinese man had a huge abdominal mass with abdominal distention and a significant reduction of food consumption. An enhanced abdominal and pelvic computed tomography and positron emission tomography–computed tomography revealed multiple cystic masses on the peritoneum, greater omentum, small intestinal mesentery and the surface of the spleen, and a high maximum standardized uptake value of the largest cystic lesion. Exploratory laparotomy was performed, and multiple cystic masses were found on the surface of the peritoneum, greater omentum, mesentery of the small intestine, and surface of the liver and spleen. Dark red bloody cystic fluid was present in the cystic tumor. Pathological examination showed that in the stromal components, the irregular vascular wall was thin. The vessel lumen was interlinked, and the lumen was lined with flat endothelium. According to the intraoperative findings and pathologic results, the patient was diagnosed with peritoneal cavernous hemangiomatosis.CONCLUSION The possibility of peritoneal cavernous hemangiomatosis should be considered when multiple cystic masses are found in the abdominal cavity by preoperative examination.