卵巢甲状腺肿类癌1例报告并文献复习.docVIP

卵巢甲状腺肿类癌1例报告并文献复习 赖琼 (湖南师范大学附属湘东医院412200) 摘要：目的探讨卵巢甲状腺肿类癌(strumal carcinoid of the ovary)的临床 病理特征及组织起源。方法通过光镜及免疫组化观察，并结合临床资料及相关 文 献复习，探讨卵巢甲状腺肿类癌的临床病理学特征、鉴别诊断及组织起源。 结果患者以盆腔块为主要表现。巨检肿瘤为单纯型。镜检肿瘤由类癌与甲状 腺滤泡 两种成分构成。免疫表型：类癌细胞Syn、CgA均阳性，Tg, CT及CK7均 阴性；甲状腺滤泡上皮Tg和CK7均阳性。结论卵巢甲状腺肿类癌是一种罕见 的低度 恶性卵巢生殖细胞肿瘤，起源于内胚层，其诊断及鉴別诊断主要依靠组织病 理学特征及免疫表型。 关键词：卵巢肿瘤；甲状腺肿类癌；免疫组化 Strumal Carcinoid of Ovary:One Case Report and Review of Literature Lai Qiong 【Abstract】 Objective: To analyze the clinicopathologic characteristics, histological origination of strumal carcinoid of the ovary. Methods: Method To discuss strumal carcinoid of ovary clinicopathologic features, differentia/diagnosis and histological origination by microscopy and immunohistochemical observation ,combing with clinical presentation and literature review. Results: One patient was with pelvic mass as the main performance.The patients with giant tumor is of simple inspection.The tumor had distinct component of carcinoid and struma .The immunohistochemistry of the former was positive for Syn and CgA,negative for Tg,CT and CK7; the latter was positive for Tg and CK7. Conclusions: Strumal carcinoid of orary is a very rare germ cell tumour, derived from multidirectional defferentiations of endodermal origin with low grade malignant.. Its diagnosis must based on the pathology and immunohistochemistry. Key words: ovarian neoplasms; strumal carcinoid; immunohistochemistry 卵巢甲状腺肿类癌(strumal carcinoid of the ovary)是一种非常罕 见的生殖细胞肿瘤，由类癌和卵巢甲状腺滤泡两种成分构成。到B 前为止，国外己有报告约100多例，国内报告较少，且多为个案报道。 其病理学特征独特，组织起源尚有争议。本文报告1例卵巢甲状腺 肿类癌，应用免疫组化检测，结合相关文献资料进行讨论，着重探 讨其组织起源、临床组织学特点及鉴别诊断。 1.病历摘要女，43岁。发现盆腔包块7月就诊。妇检：左附件 区扪及一囊性包块，大小约6*5cm无压痛。B超示左附件区囊性包 块，大小约7times;5times;4cm。实验室检查：血尿常规、肝肾功能正常， 血 FT3稍降低。术中行全子宫、双附件切除。巨检：卵巢囊实性肿物， 5times;4times;2cm大小，包膜完整，大部分为实性，灰黄，质中等偏硬。 镜 检：肿物实性区主要由甲状腺滤泡和类癌细胞组成。前者为人小不 等的甲状腺滤泡，内衬单层立方上皮，滤泡中可见胶质成分。后者 由排列成岛状、梁状的瘤细胞组成，以梁状为主，瘤细胞核大小一 致，呈圆形或卵圆形，染色质均匀，胞浆丰富，嗜酸性。类癌细胞 与甲状腺滤泡无明显界限，类癌细胞中混有多少不等的甲状腺滤泡。 免疫组化：甲状腺滤泡上皮细胞Tg(+, CK7(+)；类癌细胞Syn(+)， CgA(+), CT(-), CK