卵巢无性细胞瘤6例临床病理分析  

A Clinicopathologic Analysis of 6 Cases with Ovarian Dysgerminoma

作　　者：戴莉萍 徐国萍[2] 

机构地区：[1]云南省大理州人民医院病理科,大理671000 [2]大理学院基础学院病理教研室,大理671000

出　　处：《中国医药导刊》2010年第3期382-383,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨卵巢无性细胞瘤的临床病理特征、诊断与鉴别诊断。方法:分析6例卵巢无性细胞瘤的临床病理特征并进行文献复习。结果:6例均为手术切除标本,其中4例术中行冰冻切片检查,平均年龄18岁,临床表现下腹胀痛4例,腹部包块2例,血性胸腹水1例,血清LDH升高3例,AFP升高1例,镜下肿瘤细胞被窄的纤维组织分隔呈巢状、岛屿状、条索状,纤维隔内有多少不等的淋巴细胞浸润,瘤细胞与核的大小外观呈明显一致性,胞质丰富淡染,核大圆形,核仁明显,坏死易见。免疫组化示肿瘤细胞PLAP、NSE不同程度阳性(+)。结论:典型无性细胞瘤诊断不难,但取材较少、或镜下形态不典型、尤其在冰冻切片时易与恶性淋巴瘤混淆,需综合临床,镜下特点及免疫组化等进行鉴别,血清LDH升高有助于无性细胞瘤诊断。Objective：To investigate the clinicopathologic features,diagnosis and differential diagnosis of dysgerminoma of ovary. Methods：The clinicopathologic features of 6 cases with ovarian dysgerminoma were analyzed in addition to review of the relevant literature. Results：All the cases had surgical excision of the ovary,with four cases experiencing surgical frozen section.The average age was 18 years old. The clinical manifestation included 4 cases with inferior belly swelling pain,2 cases with abdominal mass,1 case with bloody pleural fluid and ascites,3 cases with elevated serum LDH,and 1 case with elevated serum AFEMicroscopically, tumor cells were separated like nests,islands and cords by fibrous belts which were thin and contained infiltrated lymphocytes.The size and appearance of the tumor cells and nuclei presented as obvious consistency with rich and light-stain cytoplasm,large and round nuclei,clear nucleolus and obvious necrosis.hnmunohistochemistry showed different positive stain of PALP and NSE of the tumor cells.Conclusion：Typical ovarian dysgerminoma can be diagnosed easily, but it may be confused with malignant lymphoma if fewer samples,atypical microscopic appearances and frozen section in particular are present. Differential diagnosis needs to be made in combination with clinics,microscopic features and immunohistnchemistry,and elevated serum LDH contribute to the diagnosis of dysgerminoma.

关 键 词：无性细胞瘤 卵巢 临床病理 免疫组化 

分 类 号：R737.31[医药卫生—肿瘤]