附睾原发性恶性间皮瘤2例临床病理特点  

Primary malignant mesothelioma of epididymis:a clinicopathologic study

作　　者：程虹[1] 马福成[1] 张传山[1] 袁建林[2] 胡佩臻[1] 

机构地区：[1]第四军医大学西京医院病理科,西安710033 [2]第四军医大学西京医院泌尿外科,西安710033

出　　处：《诊断病理学杂志》2003年第5期267-269,i004,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　探讨附睾原发性恶性间皮瘤的临床病理特征、诊断与鉴别诊断要点。方法　对 2例附睾原发性恶性间皮瘤进行临床病理分析、组织形态学、组织化学及免疫组化染色观察 ,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果　 2例附睾原发性恶性间皮瘤呈上皮样组织学改变 (上皮样型间皮瘤 ) ,在纤维性间质背景中 ,含有片状、灶状或巢状上皮细胞团 ,局部有腺样结构形成。淀粉酶消化的PAS染色瘤细胞呈 (- ) ,网织纤维染色显示上皮性肿瘤特点 ,局部呈双向分化 ;免疫组化染色显示瘤细胞calretinin(+) ,EMA强 (+) ,vimentin弱(+) ,CEA(- )。结论　原发于附睾的恶性间皮瘤是一种罕见的恶性肿瘤 ,预后差 ,临床易误诊。其组织形态复杂多样 ,应注意与附睾的良性增生性病变及腺癌和梭形细胞肿瘤等鉴别。Objective To summarize the clinicopathologic characteristics and to analyze differential diagnosis of primary malignant mesothelioma of the epididymis from other tumors located within the epididymis. Methods Two cases of primary malignant mesothelioma of the epididymis were observed with pathologic examination and the literaturenas briefly reviewed . Results Two men presented a testicular mass and intrascrotal pain. Histologically, primary malignant mesothelioma of the epididymis was characterized by fibrous component and the neoplastic cells arranged in stream-or nest-or cabinet-like forms. Immunohistochemical staining showed that the neoplastic cells were positive for Calretinin, epithelial membrane antigen (EMA) and vimentin, but negative for carcinoembryonic antigen (CEA). Conclusion Primary malignant mesothelioma of the epididymis is a rare male malignant paratesticular tumor arising from the mesothelial cells with poor prognosis. With the combination of clinical, histopathological and immunohistochemical data, its correct diagnosis and differential diagnosis can be made.

关 键 词：恶性间皮瘤 附睾 原发性 临床病理特点 瘤细胞 免疫组化染色 局部 组织化学 分化 PAS染色 

分 类 号：R730[医药卫生—肿瘤] R734[医药卫生—临床医学]