卵巢囊性肿瘤伴附壁结节的病理分析

目的观察卵巢囊性肿瘤中附壁结节的临床表现、组织病理学和免疫表型特征,强调诊断标准并探讨病因机制及预后。方法分析4例卵巢囊性肿瘤中附壁结节的临床资料、组织学形态及其免疫学表型,并复习相关文献。结果 4例卵巢囊性肿瘤类型较为多样,其中2例黏液及浆液性囊腺瘤,1例浆液性囊腺瘤,1例黏液性囊腺瘤。病例1为形态温和的梭形细胞附壁结节,免疫组化仅表达Vimentin;病例2为良性梭形细胞附壁结节,梭形细胞核二端钝圆,VG染色呈黄色,Vimentin、SMA、desmin阳性;病例3为恶性梭形细胞肉瘤样附壁结节,细胞呈蝌蚪状,胞质丰富红染,核分裂象易见,Desmin、MyoD1阳性;病例4为类癌附壁结节,肿瘤细胞小,大小形态一致,呈腺样或巢状排列,CK、S-100、NSE、Syn、CgA阳性。结论发生于卵巢非黏液性上皮性肿瘤中的附壁结节并非十分罕见,附壁结节具有广泛的病理形态图像谱,但由于恶性的附壁结节在囊内生长,且肉眼界限清楚,其生长方式决定了随着囊性肿瘤被早期切除后患者的预后较好。

Clinical pathological features of mural nodules in ovarian cystoid tumor

Objective To observe the characteristics of the clinical manifestation,histopathology and immunophenotype in the ovarian cystic tumors with mural nodules,emphasizing on the diagnostic criteria,pathogenesis and prognosis.Methods The clinical data,the micropathology and the immunophenotype were analyzed.Results 4 cases of ovarian cystic tumors with diversity were studied,including 2 cystoadenomas,1 serous cystoadenoma and 1 mucinous cystoadenoma.Case 1 was bland mural nodule of spindle cells expressing viment...