卵巢非特异性类固醇细胞瘤临床病理分析  

Ovarian steroid cell tumor,not otherwise specified:a clinicopathologic study

作　　者：叶绿[1] 吴秀丽[1] 徐炼[1] 黄芹[1] 孙亮[1] 何英[1] 杨开选[1] 

机构地区：[1]四川大学华西第二医院病理科,成都610041

出　　处：《中华病理学杂志》2007年第8期516-520,共5页Chinese Journal of Pathology

摘　　要：目的探讨卵巢非特异性类固醇细胞瘤的临床、病理学特征以及诊断、治疗。方法对8例卵巢非特异性类固醇细胞瘤进行 HE 和免疫组织化学(EliVision 法)染色及特殊染色,结合临床资料和文献进行分析。结果 7例良性非特异性类固醇肿瘤,肿瘤主要由两种细胞构成:一种为多角形细胞,胞质含小颗粒或嗜酸性;一种为胞质含空泡的较大细胞。细胞排列成巢或条索状,似肾上腺球状带和束状带。1例恶性非特异性类固醇肿瘤,细胞呈明显异型性,核分裂象7/10 HPF,伴出血、坏死。免疫组织化学显示:肿瘤细胞胞质内钙结合蛋白和α-抑制素普遍阳性表达。诊断非特异性类固醇细胞瘤需与广泛黄素化的颗粒细胞瘤、卵泡膜细胞瘤、富于脂质的支持细胞瘤和嗜酸型透明细胞癌等相鉴别。良性肿瘤治疗一般为肿瘤切除或加患侧附件切除术;恶性肿瘤行肿瘤加附件切除,辅以化疗或促性腺激素激动剂治疗。结论非特异性类固醇细胞瘤是类固醇细胞肿瘤中最常见的类型,良性多见;免疫组织化学可辅助肿瘤诊断;治疗方法主要取决于肿瘤的良恶性。Objective To study the clinicopathologic features, diagnostic criteria, differential diagnosis and treatment options of ovarian steroid cell tumor, not otherwise specified （NOS）. Methods Light microscopy and immunohistochemical study was carried out in 8 cases of ovarian steroid cell tumor, NOS. The literature was reviewed. Results The 7 cases of benign ovarian steroid cell tumor, NOS were composed mainly of polygonal cells with granular eosinophilic cytoplasm and larger cells with vacuolated cytoplasm. They resembled the architecture of normal adrenal gland, with formation of cell nests and trabeculae. The single case of malignant ovarian steroid cell tumor had evidence of significant cellular pleomorphism, haemorrhage and coagulative tumor necrosis. The mitotic count measured about 7 per 10 high-power fields. Immunohistochemical study showed that the tumor cells expressed calretinin and α-inhibin. Differential diagnosis included oxyphilic granulosa cell tumor, thecoma, Sertoli cell tumor and clear cell carcinoma. The treatment options of benign ovarian steroid cell tumor, NOS was local excision or ipsilateral salpingo-oophorectomy, while the malignant counterpart should be treated with a combination of surgery and chemotherapy, including administration of GnRH agonist. Conclusions Ovarian steroid cell tumor, NOS, is the most common type of ovarian steroid cell tumors. Most of which are associated with a benign clinical outcome. Immunohistochemistry is an important adjunct for diagnosis. The treatment options of ovarian steroid cell tumor, NOS depend on its malignant potential.

关 键 词：卵巢肿瘤 病理学 临床 免疫组织化学 

分 类 号：R737.31[医药卫生—肿瘤]