女性Wolffian附件瘤临床病理观察

目的 探讨女性Wolffian附件肿瘤的临床病理特点、免疫表型及鉴别要点.方法 报告2例Wolffian附件瘤的临床病理资料,通过常规病理检查及免疫组化染色观察其形态学特征,并结合有关文献进行讨论.结果 2例肿瘤均为单侧,位于阔韧带,年龄分别为68岁和45岁.镜下肿瘤细胞呈弥漫实性或筛网状分布,弥漫实性区可见成片稍肥胖的梭形或卵圆形细胞及紧密排列的管状结构,管腔内衬立方或柱状上皮,后者似支持细胞样细胞;瘤细胞无明显异型,也无核分裂;管周有PSA(+)的基膜样物质.免疫组化:瘤细胞CKpan、vimentin、WT1和S-100(+),CK5/6、CK7、CD10、CD99、α-Inhibin、MC、calretinin、ER、PR、EMA和SMA均(-).结论 如果Wolffian附件瘤是一少见的妇科肿瘤,发生于Wolffian管沿线部位,易与卵巢的支持细胞瘤、腺瘤样瘤等肿瘤混淆,管样结构和筛网状结构是其特征性改变.该瘤是低度恶性肿瘤,需长期随访观察.

Femal adnexal tumour of wolffian:two cases report and review of literature

Objective To explore the clinicopathological and immunohistochemical features, diagnosis and differential diagnosis of female adnexal tumour of Wolffian (FATW). Methods Two FATW cases were analyzed by HE stain, in which one case was stained by immunohistochemisby, and related literature was reviewed. Results Two cases cases occurred in female, and the age of patients ranged from 45 to 68 years. All 2 cases of FATW were unilateral and located in the broad ligament. The tumour cells were arranged in diffuse or solid sheets and retiform, with closely packed tubular formation in the solid sheets. The tubes were lined by cubical epithelial or columnar epithelia that liked Sertoli cells. The tumor cells were spindle or polygonal with no obvious atypia, and mitotic figures were rare. Basement membrane was positive for PAS. The tumour cells were positive to Ckpan,vimentin, WT, S-100, CK5/6, CK, CD10, CD99, a-inhibin and MC calretinin, but negative to ER, PR, EMA and SMA.Conclusion FATW is a rare tumor and locates in the area where Wolffian duct remnants are, easily confused with Sertoli cell tumours and adenomatoid tumor of ovaries. Tubes and retiform formation are the distinctive clinicophathological features. FATW is low potential malignancy and needs a long-term follow-up.