儿童睾丸间质病变9例临床病理分析  

Testicular interstitial cell lesions in children:a clinicoathologic study of nine cases

作　　者：牛会林 伊鹏 高秋 王凤华 夏建清 李丽萍 NIU Hui-lin;YI Peng;GAO Qiu;WANG Feng-hua;XIA Jian-qing;LI Li-ping(Department of Pathology,Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China;Department of Endocrinology and Metabolism,Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China)

机构地区：[1]广东省广州市妇女儿童医疗中心病理科,广州510623 [2]广东省广州市妇女儿童医疗中心儿童内分泌代谢科,广州510623

出　　处：《临床与实验病理学杂志》2020年第4期426-430,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨儿童睾丸间质病变的临床病理学特征。方法回顾性分析9例儿童睾丸间质病变的临床病理学及免疫表型特征,并复习相关文献。结果9例儿童睾丸间质病变,年龄1.9~16岁,平均8.3岁。男童7例,2例社会性别为女,染色体核型均为46XY。临床表现:1例性早熟,2例性发育异常,5例主要表现为睾丸肿瘤,1例为先天性肾上腺皮质增生症并睾丸肿瘤。4例性激素水平升高。B超提示7例睾丸肿瘤,2例为双侧隐睾。病理检查:睾丸病变双侧3例,单侧6例,其中左侧4例,右侧2例;病灶直径0.1~3.0 cm。镜下观察Leydig细胞增生4例,Leydig细胞瘤4例,睾丸肾上腺残余肿瘤1例。免疫表型:Leydig细胞均表达α-inhibin、vimentin、Melan-A和Calretinin,睾丸肾上腺残余肿瘤亦可见α-inhibin、vimentin及Melan-A不同程度表达,Syn局灶表达,不表达Calretinin;8例均不表达AR。结论儿童睾丸间质病变罕见,明确不同病变的临床病理特征具有重要意义。Purpose To investigate the clinicopathological features of children with testicular interstitial lesions.Methods The clinical and pathological features of 9 cases of testicular interstitial lesions in children were collected and the relevant literatures were reviewed.Results Nine patients with testicular interstitial lesions were aged from 1.9 to 16 years,with an average age of 8.3 years.There were 7 males and social gender with female in 2 cases,with chromosomal karyotype of 46XY.Clinical manifestations included precocious puberty(1 cas),disorders of sexual development(2 cases),testicular tumors(5 cases),congenital adrenal hyperplasia and testicular tumor(1 case),and elevated sex hormone levels(4 cases).B-ultrasound showed that 7 cases had testicular tumors and 2 cases were bilateral cryptorchidism.Histopathologically,3 cases had bilateral testicular lesions and 6 cases had unilateral lesions,including 4 cases of left side and 2 cases of right side.And the diameter of lesions ranged 0.1-3.0 cm.Microscopically,4 cases were Leydig cell hyperplasia,4 cases were Leydig cell tumor,and 1 case was testicular adrenal rest tumor.Immunohistochemically,Leydig cells expressedα-inhibin,vimentin,Melan-A and Calretinin.α-inhibin,vimentin and Melan-A were positive and Calretinin was negative in testicular adrenal rest tumor.8 cases were all negative for AR.Conclusion Testicular interstitial lesions in children are rare,and it is important to define the clinicopathological features of different lesions.

关 键 词：睾丸肿瘤 肾上腺残余肿瘤 LEYDIG细胞瘤 Leydig细胞增生 性发育异常 儿童 

分 类 号：R737.21[医药卫生—肿瘤]