卵巢低分化Sertoli-Leydig细胞瘤临床病理分析  

Clinicopathological features of poorly differentiated Sertoli-Leydig cell tumor of the ovary

作　　者：高嫄 刘雯[1] 黄亚冰[1] GAO Yuan;LIU Wen;HUANG Ya-bing(Department of Pathology,Renmin Hospital of Wuhan University,430060,China)

机构地区：[1]武汉大学人民医院病理科,武汉430060

出　　处：《诊断病理学杂志》2022年第12期1124-1127,共4页Chinese Journal of Diagnostic Pathology

基　　金：中央高校基本科研业务费专项资金青年教师资助项目(2042020kf0076)。

摘　　要：目的探讨卵巢Sertoli-Leydig细胞瘤(SLCT)的临床病理学特点和免疫表型。方法回顾性分析1例卵巢SLCT的临床病理学特征及诊断思路,并复习相关文献。结果患者为19岁女性,因间断下腹胀痛1周入院,影像学示下腹部、盆腔巨大囊实性占位(大小17.8 cm×11.2 cm),盆腔、腹壁多发强化结节,后经病理活检,镜下见肿瘤细胞形态呈肉瘤样,异型性明显,片状及巢团状分布,可见大量病理性核分裂象(>5/10HPF),伴出血及坏死,局部可见高分化的Sertoli细胞形成腺管样结构,未见异源性成分。免疫表型:肿瘤细胞表达α-inhibin、CK、Calretinin、CD99、CD10和CD56。结论卵巢SLCT是一种罕见的妇科肿瘤,与许多妇科肿瘤有形态学上的交叉,在临床诊断工作中,需要结合临床表现,镜下形态及免疫组化综合考虑,必要时应做基因检测辅助诊断。Objective To investigate the clinicopathological features and immunophenotype of ovarian Sertoli-Leydig cell tumor(SLCT).Methods The clinicopathological features and diagnosis of a case of ovarian SLCT were retrospectively analyzed,and related literatures were reviewed.Results The patient was a 19-year-old female who was admitted to hospital because of intermittent lower abdominal distension and pain for 1 week.Imaging showed a huge cystic and solid mass in the lower abdomen and pelvis(size 17.8 cm×11.2 cm),and multiple enhancing nodules in the pelvis and abdominal wall.Pathological biopsy found the tumor cells were sarcoma-like morphology,with obvious atypia,distributed in sheets and nests,and a large number of pathological mitotic figures(>5/10 HPF),accompanied by hemorrhage and necrosis,which were locally visible well-differentiated Sertoli cells forming duct-like structures without any heterologous components.Immunohistochemically,tumor cells expressedα-inhibin,CK,calretinin,CD99,CD10 and CD56.Conclusion Ovarian SLCT is a rare gynecological tumor and it has morphological overlap with many other gynecological tumors.In clinical diagnosis,it is necessary to combine clinical manifestations,microscopic morphology and immunohistochemistry.Genetic testing should be done to assist diagnosis when necessary.

关 键 词：卵巢 Sertoli-Leydig细胞瘤 低分化 DICER1 

分 类 号：R737.31[医药卫生—肿瘤]