宫颈原发性透明细胞癌临床病理观察  

Clinicopathological features of primary clear cell carcinoma of cervix

作　　者：韩梅[1] 李惠[1] 高丽丽[1] 章宜芬[1] Han Mei;Li Hui;Gao Lili;Zhang Yifen(Department of Pathology,Jiangsu Province Hospital of Chinese Medicine,Jiangsu Nanjing 210029,China)

机构地区：[1]江苏省中医院病理科,江苏南京210029

出　　处：《现代肿瘤医学》2020年第18期3207-3210,共4页Journal of Modern Oncology

摘　　要：目的:探讨宫颈原发性透明细胞癌的临床病理学特征、鉴别诊断要点,提高对其认识。方法:回顾性分析1例宫颈原发性透明细胞癌,分析其病理组织学和免疫表型特征,并复习相关文献。结果:患者,女性,58岁,绝经8年。30年前因"卵巢囊肿"行手术治疗。宫颈B超未见明显新生物及溃疡。巨检示宫颈至宫颈管质硬,环绕管壁一周,质硬处切面灰白灰黄色,实性,界不清。镜下见肿瘤大部分由较小并且相对规则的乳头构成,有时可见含有纤维血管轴心的大乳头,乳头轴心可透明变性。部分区域显示扩张的腺体被覆单层扁平及立方上皮细胞。肿瘤细胞呈中重度异型增生,胞质透明,细胞呈多边形。部分区域细胞呈鞋钉样,细胞核呈染色质深染,部分有明显核仁,细胞突向腺腔内。其他部位未发现子宫内膜异位改变。免疫标记PAX8、NapsinA显示弥漫强阳性,p16显示局灶强阳性,p53显示斑驳状阳性。结论:宫颈原发性透明细胞癌是一种罕见的肿瘤,诊断依据其病理组织学形态及免疫表型,要注意与宫颈原发性腺癌及转移性癌相鉴别。Objective:To clarify the clinicopathologic features,differential diagnosis of primary clear cell carcinoma of the cervix.Methods:The histopathological and immunohistochemical features of one case with primary clear cell carcinoma of the cervix and the related literature were analyzed retrospectively.Results:Fifty-eight years old woman was eight years postmenopausal.Surgery was performed because of ovarian cyst thirty years ago.No obvious new organisms and ulcers were found in cervical by ultrasound.Giantly,the round wall was hard of the tube of the cervix and the section showed gray-white and gray-yellow,solid and unclear boundaries.Microscopically,the tumors consist mostly of smaller and relatively regular papillae,sometimes with large papillae containing a fiber-vessel axis that was transparent and degenerative.Some areas showed dilated glands covered with a single layer of flat and cuboidal cells.The tumor cells showed moderate and severe dysplasia that were polygonal and the cytoplasm were transparent.Some of the cells were shoe-pin-like,and the nucleus showed chromatin hyperchromatic.Some had obvious nucleoli,and the cell processed into the glandular cavity.Endometriosis was not found in other locations.Immunological markers PAX8 and NapsinA showed diffuse strong positive,p16 showed local lesion strong positive and p53 staining showed mottled positive.Conclusion:Primary clear cell carcinoma of the cervix is a rare tumor.The diagnosis should be based on its histopathological morphology and immunophenotype.It should be differentiated from other primary adenocarcinoma and metastatic carcinoma of the cervix.

关 键 词：宫颈 透明细胞癌 原发 

分 类 号：R737.33[医药卫生—肿瘤]