卵黄囊瘤32例临床病理剖析.docVIP

卵黄囊瘤32例临床病理剖析 　　【摘要】 目的：探讨卵黄囊瘤（yolk sac tumour，YST）的临床病理特征、免疫组化特点、诊断及鉴别诊断，以提高对YST的认识。方法：回顾性分析2008-2015年本院确诊的32例YST患者的临床病理特征及免疫组化染色结果，并复习相关文献，进行对比总结。结果：32例YST患者中男19例，女13例，年龄7个月～50岁（平均12.6岁），肿瘤发生于睾丸17例，卵巢10例，性腺外5例。病理标本镜检可见到特征性的S-D小体，疏松网状结构，及细胞内外的透明小体。免疫表型可见32例Glypican-3、CK、SALL4均（+），CD30、hCG、CD117、EMA、CD15、CK7、ER、PR均（-），28例AFP（+），20例vimentin（+），5例PLAP（灶+），2例OCT4（灶+），Ki-67增殖指数大于50%。结论：YST是一种少见的生殖细胞肿瘤，发生于性腺外时容易误诊，可依靠组织学特点及免疫组化结果进行明确诊断。 　　【关键词】 卵黄囊瘤； 临床病理； 鉴别诊断； 免疫组织化学 　　中图分类号 R730.45 文献标识码 B 文章编号 1674-6805（2016）17-0048-03 　　【Abstract】 Objective：To improve the cognition about the yolk sac tumor（YST） by exploring the clinicopathological characteristics，immunohistochemical characteristics，diagnosis and differential diagnosis of YST.Method：Thirty-two cases of YST were selected and the clinicopathological characteristics and immunohistochemical staining were retrospective analyzed，and the relevant literature were reviewed and compared.Result：Among the 32 cases with YST，19 cases in males，13 cases in female，the average years old was 12.6 ranging from 7 months to 50 years old.As to the occurrence site，17 cases were found in testis，10 cases were found in ovary and 5 cases were found in extragonadal sites.The microscopical result showed characteristic Schiller-Duval bodies，loose reticular structure and hyaline droplets in the tumor tissue.The immunohistochemistry showed Glypican-3，CK and SALL4 were expressed in all of cases，while CD30，hCG，CD117，EMA，CD15，CK7，ER and PR were not expressed in all of the cases.The expression of AFP with different levels were found in 28 cases.Vimentin were expressed in 20 cases.The spotty expression of PLAP was showed in 5 cases.The spotty expression of OCT4 was showed in only 2 cases.The proliferative index of Ki-67 was more than 50%.Conclusion：YST is a rare germ cell tumor，which is easy to be misdiagnosed when appeared in extragonadal sites.The correct diagnosis of YST is mainly depended on histopathology and immunohistochemical staining. 　　【K