以颈部淋巴结转移为首发症状的卵巢浆液性乳头状癌2例临床病理观察  

Serous papillary ovarian cancer with cervical lymph node metastasis as the first symptom: a clinicopathological study of two cases

作　　者：赵涓涓[1] 张弘[1] 江忍 张军[1] 来旭[2] ZHAO Juan-juan;ZHANG Hong;JIANG Ren;ZHANG Jun;LAI Xu(Department of Pathology,Ezhou Central Hospital,Ezhou 436000,China;Department of General Surgery,Ezhou Central Hospital,Ezhou 436000,China)

机构地区：[1]鄂州市中心医院病理科,湖北鄂州436000 [2]鄂州市中心医院普外科,湖北鄂州436000

出　　处：《诊断病理学杂志》2020年第3期195-198,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨以颈部淋巴结转移为首发症状的卵巢浆液性乳头状癌的临床病理特点、形态学特征及鉴别诊断。方法回顾性分析2例以颈部淋巴结转移为首发症状的两例卵巢浆液性癌的临床情况、组织学形态及免疫表型,并复习相关文献,总结该肿瘤的诊断与鉴别诊断。结果 2例以颈部淋巴结转移为首发症状的卵巢浆液性乳头状癌患者年龄分别为54岁和64岁,首发症状均为左颈部淋巴结肿大。镜下见淋巴结内大量呈乳头状、片状分布的异型细胞及砂粒体,异型细胞核级别高,核分裂像易见,免疫组化检测均表达WT-1、CA-125、CK7、ER和CD99。结论晚期卵巢浆液性癌可以远隔体表淋巴结转移为首发症状。结合临床情况,组织学形态特征及免疫组化表达情况综合分析是确诊的关键。To investigate the clinicopathological features,morphological features and differential diagnosis of ovarian serous papillary carcinoma with cervical lymph node metastasis as the first symptom. Methods Two cases of ovarian serous carcinoma with cervical lymph node metastasis as the first symptom were retrospectively analyzed in terms of clinical manifestations,histological morphology and immunophenotype. The relevant literature was reviewed to summarize the diagnosis and differential diagnosis of the tumor. Results Two cases of ovarian serous papillary carcinoma with cervical lymph node metastasis as the first symptom aged 54 and 64 years,respectively. The first symptom was left cervical lymph node enlargement. Microscopically,a large number of papillary and fleets of atypical cells and psammoma bodies were found in lymph nodes. The nuclear grade of atypical cells was high and mitotic figures were easy to find.Immunohistochemical staining showed that WT-1,CA-125,CK7,ER and CD99 were all expressed. Conclusion Advanced ovarian serous cancer can be the first represented as distant lymph node metastasis. Combined with the clinical situation, the key to the diagnosis is the comprehensive analysis of histological morphological characteristics and immunohistochemical expression.

关 键 词：卵巢浆液性癌 颈部淋巴结 转移 

分 类 号：R733.4[医药卫生—肿瘤]