卵巢甲状腺肿类癌伴成熟性囊性畸胎瘤临床病理学观察并文献复习  

Clinicopathological observation and literature review of ovarian goiter carcinoid with mature cystic teratoma

作　　者：王梦萍 袁静萍[1] 饶洁[1] Wang Mengping;Yuan Jingping;Rao Jie(Department of Pathology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Pathology,Taikang Tongji(Wuhan)Hospital,Wuhan 430050,China)

机构地区：[1]武汉大学人民医院病理科,武汉430060 [2]泰康同济(武汉)医院病理科,武汉430050

出　　处：《中国组织化学与细胞化学杂志》2023年第2期182-185,共4页Chinese Journal of Histochemistry and Cytochemistry

基　　金：湖北省卫生健康科研基金资助(WJ2021M151)。

摘　　要：目的探讨卵巢甲状腺肿类癌伴成熟性囊性畸胎瘤的临床病理学特征、免疫表型、诊断及鉴别诊断、治疗及预后。方法一例36岁、体检B超发现右侧附件区混合性包块的女性患者,入院行右侧附件包块切除术并做相关组织病理学及免疫组织化学检测。采用Envision法免疫组织化学染色,检测嗜铬蛋白A、突触素、CD56、S-100、上皮膜抗原、Ki-67、甲状腺球蛋白、CK19、半乳糖凝集素3、甲状腺过氧化物酶、降钙素免疫反应性。结果术后病理标本显示实性区由甲状腺滤泡组织和具有神经内分泌特征的类癌成分混合组成。高倍镜下,在正常甲状腺滤泡组织间混合的类癌成分以小梁状及岛状结构为主,偶见腺状结构,肿瘤细胞形态温和,胞质丰富,嗜酸性,细胞核染色质细腻,呈椒盐样。囊性区镜下呈成熟性囊性畸胎瘤表现。类癌区域嗜铬蛋白A、突触素、CD56弥漫散强阳性,上皮膜抗原阳性,S-100阴性,肿瘤细胞Ki-67增殖指数2%;甲状腺滤泡组织甲状腺球蛋白、上皮膜抗原、CK19、半乳糖凝集素3、甲状腺过氧化物酶阳性,降钙素阴性。病理诊断为卵巢甲状腺肿类癌伴成熟性囊性畸胎瘤。结论该肿瘤镜下由由甲状腺滤泡组织及类癌组织组成,不同组织成分的免疫组织化学表型特征较明显,有利于两种组织成分的诊断与鉴别。Objective To investigate the clinicopathological features,immunophenotype,diagnosis and differential diagnosis,treatment and prognosis of ovarian goiter carcinoid tumor with mature cystic teratoma.Methods A 36-year-old female patient with a mixed mass in the right adnexal region detected by ultrasound was admitted to the hospital for excision of the right accessory mass.Then,the relevant histopathological and immunohistochemical exminations were performed.Envision immunohistochemical staining was used to detect the immunoreactivities of chromaffin A,synapsin,CD56,S-100,epithelial membrane antigen,Ki-67,thyroglobulin,CK19,galactose lectin 3,thyroid peroxidase and calcitonin.Results The postoperative pathological specimen showed a solid area consisting of a mixture of thyroid follicular tissue and carcinoid tissue with neuroendocrine features.At high magnification,the mixed carcinoid tissues between normal thyroid follicular tissue were mainly trabecular and insular structures,with occasional glandular structures,and the tumor cells had mild morphology,abundant cytoplasm,eosinophilic,and fine chromatin of the nuclei,which were peppery.The cystic area showed mature cystic teratoma microscopically.The carcinoid area was strongly positive for chromoprotein A,synapsin,CD56 diffusion,positive for epithelial membrane antigen,negative for S-100,Ki-67 proliferation index of tumor cell 2%;thyroid follicular tissue was positive for thyroglobulin,epithelial membrane antigen,CK19,galactose agglutinin 3,thyroid peroxidase,and negative for calcitonin.The pathological diagnosis was carcinoid tumor of the ovarian thyroid with mature cystic teratoma.Conclusion The tumor is composed of thyroid follicular tissue and carcinoid tissue under the microscope.The immunohistochemical phenotypic characteristics of different tissue components are obvious,which is conducive to the diagnosis and differentiation of the two tissue components.

关 键 词：卵巢恶性肿瘤 卵巢甲状腺肿类癌 畸胎瘤 

分 类 号：R365[医药卫生—病理学]