卵巢肝样癌的临床病理特点  

Clinicopathological characteristics of ovarian hepatoid carcinoma

作　　者：范嫏娣[1] 冬国友[2] 王展宏[3] 

机构地区：[1]天津市人民医院病理科,天津300121 [2]唐山市人民医院,河北唐山063000 [3]天津医科大学附属肿瘤医院,天津300060

出　　处：《诊断病理学杂志》2008年第2期103-106,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨卵巢肝样癌的卵巢病理特点及其诊断和鉴别诊断要点。方法采用光镜、免疫组化对2例卵巢肝样癌进行临床病理分析并对肿瘤的来源进行探讨,同时系统复习文献资料。结果2例患者年龄分别为34岁和54岁,主诉均为下腹部肿物近日迅速增大,分别伴尿频及下腹坠胀,全身检查无占位性病变;妇科及盆腔B超检查证实为卵巢肿瘤,遂行患侧卵巢肿瘤切除术。病理检查示2例分别为右侧及左侧卵巢肿瘤,直径5cm及15cm,以实性为主;光镜下瘤细胞肥硕,呈多角形,胞质嗜酸或富含类脂质,核居中,核仁明显,呈条索状或巢状排列,常伴有不规则腺腔区域,血窦丰富,易见核分裂象。免疫组化示瘤细胞AFP、AAT、CK8、CEA、hepatocyte和WT1均弥漫(+);例1衬覆腺腔的瘤细胞CA125(+),CD99、HCG和α-inhibin均(-)。结论卵巢肝样癌十分罕见,须与卵巢肝样卵黄囊瘤、宫内膜样腺癌、未分化癌、类固醇细胞肿瘤及卵巢转移性肝细胞癌鉴别,AFP和CA125(+)提示本瘤可能起源于卵巢表面上皮向肝细胞分化。Objective To study the clinicopathological characteristics, diagosis and differential diagnosis of ovarian hepatoid carcinoma. Methods 2 cases of hepatoid carcinoma of the ovary were studied with immunohistochemical staining and review of relevant literature. Results The age of two patients was 34 and 54 year old, respectively, and both of them complained frequent urination and a lower abdonfinal mass that increased in size rapidly. Physical examination revealed nothing abnormal in the liver. Gynecological and pelvic B ullxasonie examination identified a tumor mass in the ovary and surgical extirpation were performed. Pathological examination showed that the tumors were in the right and left ovary with 5 em and 15 cm in diameter, respectively. Microscopically, the tumor cells arranged in solid and tubular pattern with plenty of sinusoids, and they showed abundant eoinophilie cytoplasm and round to polygonal features, central nuclei with distinct nueleoli and active mitosis. Immtmohistochenfieally, tumor cells were positive for AFP, AAT, CK, CEA, Hepatocyte and WT1, and negative for CD99, HCG and α-inhibin, except case 1 that showed glandular cavity covered with epithelium expressing CA125. Conclusion The ovarian hepatoid carcinoma is extremely rare. Differential diagnosis of this tumor should include hepatoid yolk sac tumor, endometrioid carcinoma, steroid tumor, and tmdifferentiated carcinoma. The expression of AFP and CA125 indicates that ovarian hepatoid carcinoma might originate from the surfieial epithelium differentiating into hepatoid cells.

关 键 词：卵巢 肝样瘤 甲胎蛋白 

分 类 号：R737.31[医药卫生—肿瘤]