卵巢恶性Wolffian管来源的女性附件肿瘤临床病理观察  

Clinicopathological features of malignant female adnexal tumor of probable Wolffian origin in ovary

作　　者：刘蓉 王亚霓 王新峰[1] 史维晨 杜文欣[2] 胡建功[1] LIU Rong;WANG Ya-ni;WANG Xin-Feng;SHI Wei-chen;DU Wen-xin;HU Jian-Gong(Department of Pathology,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China;Department of Gynecology,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)

机构地区：[1]天津中医药大学第二附属医院病理科,天律300250 [2]天津中医药大学第二附属医院妇产科,天律300250

出　　处：《诊断病理学杂志》2020年第1期24-27,31,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨恶性Wolffian管来源的女性附件肿瘤(FATWO)的临床病理学特征、诊断和鉴别诊断、治疗及预后。方法对1例恶性FATWO病例进行组织形态及免疫组化染色分析,并复习相关文献。结果患者女性,68岁,B超发现左卵巢实性肿物。镜下见肿瘤细胞大部分呈密集拥挤的小管状,部分为管状裂隙、条索状及筛状结构,瘤细胞均匀一致,核分裂象少见;少部分区域肿瘤细胞呈乳头状生长,局部乳头密集、融合成片,瘤细胞异型明显,核空泡状,核分裂象约15个/10HPF,伴较多坏死;肿瘤局灶侵及输卵管外膜。免疫组化:vimentin、CD99(+),CK7、CKpan、EMA、p16部分(+);Ki-67阳性指数50%;ER、PR、inhibin-α、WT-1均(-)。结论FATWO是一种来源于中肾管残留的罕见肿瘤,恶性者更为少见,病理组织学特点及免疫组化标记有助于该病的诊断和鉴别诊断。Objective To investigate the clinical pathological features,diagnosis,differential diagnosis,treatment and prognosis of malignant female adnexal tumor of probable Wolffian origin(FATWO).Methods Histopathological morphology and immunohistochemical staining of one malignant FATWO case were analyzed,and relevant literatures were reviewed.Results A 68 years old woman with a solid mass of the left ovary was reported.Microscopically,majority of the tumor cells were densely packed tubules.Tubular cracks,cord-like arrangement and cribriform structure area were also observed.The cell size was relatively uniform and the mitotic figures were rare.The tumor cells also exhibited papillary growth patterns with dense local papilla and fused into a sheet in minority area.They were obviously atypical with vacuolar nuclei,the mitotic figures were approximate to 15/10 HPF,and accompanied by multiple focal necrosis.The outer membrane of the fallopian tube was found to be invaded by the tumor tissue.The immunohistochemical staining results showed that the tumor cells were positive for vimentin,CD99,and partially positive for CK7,CKpan,EMA and P16;Ki-67 index was approximate to 50%,while they were negative for ER,PR,inhibin-αand WT-1.Conclusion FATWO is a rare tumor originated from mesonephric duct residue,which is more rare with malignant biological behavior.The histopathological features and immunohistochemical markers are conducive to the diagnosis and differential diagnosis of this disease.

关 键 词：Wolffian管 卵巢恶性肿瘤 女性附件肿瘤 病理特征 

分 类 号：R737.31[医药卫生—肿瘤]