卵巢纤维瘤合并腹膜恶性间皮瘤临床病理观察.doc

do；IO. 3%9/j. ? 1007$096.2OI2.OLOJ3 卵巢纤维瘤合并腹膜恶性间皮瘤临床病理观察 沈虬王国庆?报丽华 （东南大学附属中大庚院病理科?啣京210009） ［摘要】目的 探讨卵巢纤维嗚台并腹获恶性间皮蝴的诊断与鉴别诊断以及可能的发病机制「方法 采用HE 染色、免疫组化拯记、临床追踪随访并复习文献对卵巢纤维瘤合并性间皮嘯进行规察分析。结果患者女 性?60岁c盆腔山位伴大誠腹水。组织学上卵集为巨大纤维痫?合并服腔弥漫性上皮样细他增生?细胞呈乳头状或 巣片状分布?异教性不明孩分裂少见.部分区域肿彌向脂肪小叶内稷润生长。免疫组化:上皮样细胞MC、CR、 D240和CK5/6（ + ） ,P16和上皮性标记物（?）。结论 卵巢纤维痛合并腹膜恶性间皮㈱罕见，发生机制不消◎形 态学上容易误诊为卵巢纤维瘤伴弥没性间皮细胞增生.腹膜或卵巢原发性浆液性肿懵?免疫标记及临床特征有助 于鉴别。 ［关fit词］卵巢纤维觸；???性间皮瘤；间皮细胞增生 ［中图分类号］R737.31【文献标识码】A ［文韋编号）1007-80X（2012）01-0046-03 Ovarian fibroma with malignant peritoneal mesotheJioma: a dinicopathologicaj study SHEN Qin. WAMG Gix-qingt ZHANG lj-hua ( [/efKirtmeni of Pathology9 Affiliated Zhangda Hospital. Soulheaxi University. Nanjing 2100()9, Chiwi) Corresponding author： ZHANG Li-hua ( E*nuiil: njlihua@ yahoo, com. cn) Abstract： Purpose To explore lhe diagnottist differential diagnosist and possible pathogenesis of the ovarian fibroma wilh malignant peritorical mesothelioma (MEM). Methods Using HE staining, imtnunohistochemif4ry t clinical followup 乙nd review of the wlnted liter?t?jn^t one owe of ovarian fibrwna with MPM was analysrd* Results llw case was of an elderly female with pelvic bump and abundant In this gse, a huge ovarian lunwr wa? fibroma. The epithelioid cells of the abdominal cavity proliferated diffuftcly t and arranged in papillan or nest-flake ?tnclure. Epithelioid cells were mild atypia and rare mitotic figures. But some of them invaded into the fatty tissue? ImnwnohiiMdmhemi別ry thawed mesothelial cell markers ( MC, CR, D2-4Ot CK5/6) were positive^ and epithelial cell markers and P16 were negative? Conclusion The ovanan fibnma with MPM is rare and its mechanism is not clear. The ovarian fibroma with MPM is difficult to be distingiiishrd from ovarian fibroma with mesothelial proliferation and ovarian/perilont^l M^rous tumor. Key words； Ovarian fibroma； Malignant peritoneal Peritoneal mesothelial cells proliferation 卵巢纤维斓是起源于卵集性索间质的肿痫，常 常会引起腹膜间皮细胞增生，出现腹胶和胸腔积液. 但纤维柿介并腹膜恶性间皮（ malignant peritoneal n