原发性双侧精囊腺黏液腺癌临床病理观察  

Clinicopathologic features of primary mucinous adenocarcinoma of the seminal vesicles

作　　者：宋志刚[1] 余春开[2] 田侠[1] 王殿军[1] 

机构地区：[1]解放军总医院病理科,北京100853 [2]首都医科大学附属北京世纪坛医院病理科,北京100038

出　　处：《诊断病理学杂志》2015年第1期34-37,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨原发性双侧精囊腺黏液腺癌的临床病理学特征、诊断与鉴别诊断。方法分析1例原发性双侧精囊腺黏液腺癌的临床、病理形态学特征、免疫表型,并复习相关文献。结果患者男性,51岁。临床表现为血精伴排尿不畅,无肉眼血尿。血PSA不高,CEA、CA19-9和CA724升高。MRI示双侧精囊腺区囊实性病变。大体见双侧精囊腺增大,切面囊实性,实性区灰黄色,囊内有淡黄色胶冻样物。镜下见大量黏液湖,囊内壁衬覆黏液细胞,细胞有重度不典型性。免疫组化示癌细胞CK7和CA125(+),CK20小灶(+),PSA和CEA均(-)。术后细生化指标下降至正常范围。随访6个月,无复发或远处转移。结论原发性精囊腺黏液腺癌非常罕见,确诊时需与毗邻脏器来源的黏液腺癌鉴别,全面检查配合免疫组化可以明确诊断。Objective To study the clinicopathologic features,diagnosis and differential diagnosis of primary bilateral mucinous adenocarcinoma of the seminal vesicles. Methods One cases of primary bilateral mucinous adenocarcinoma of the seminal vesicles was investigated by clinical findings,histopathology and immunohistochemistry,and related literatures were reviewed. Results A 51-year-old man presented with hematospermia,dysuria,but without gross hematuria. The serum marker for prostate cancer,prostate-specific antigen（ PSA） was normal. The serum CEA,CA19-9 and CA724 were slightly elevated,and back to normal after operation. Magnetic resonance imaging demonstrated a multilocular cystic mass at the bilateral seminal vesicles. Grossly,the cut surface of the bilateral seminal vesicles were cystic-solid,with grayish yellow in solid and yellow jelly in cyst. Microscopic examination revealed that the tumor was mainly composed of mucinous lakes,covered with tumor cells with severe atypia. Immunohistochemically,the tumor cells were positive for CK7 and CA125,focal positive for CK20,but negative for PSA and CEA. The patient has remained free of locally recurrent or metastatic disease for 6 months of follow-up. Conclusions Primary mucinous adenocarcinoma of the seminal vesicles（ SVCA） is a very rare neoplasm. Because of the special anatomical site of seminal vesicle gland,SVCA should be differentiated from secondary mucinous adenocarcinoma of adjacent organs. Comprehensive inspection and immunohistochemical staining are helpful to the correct diagnosis.

关 键 词：精囊腺 黏液腺癌 CA125 免疫组化 鉴别诊断 

分 类 号：R737.23[医药卫生—肿瘤]