中肾管肿瘤临床病理分析及文献复习  

Clinicopathological analysis of mesonephric duct tumors and literature review

作　　者：窦兴欣 肖芹[2] 王翠梅[2] 杨希 张子兰[2] DOU Xingxin;XIAO Qin;WANG Cuimei;YANG Xi;ZHANG Zilan(Department of Pathology,Yizheng Hospital of Chinese Medicine,Yizheng Jiangsu 211400;Department of Pathology,Northern Jiangsu People’s Hospital,Yangzhou Jiangsu 225001,China)

机构地区：[1]仪征市中医院病理科,江苏仪征211400 [2]苏北人民医院病理科,江苏扬州225001

出　　处：《临床与病理杂志》2024年第11期1597-1602,共6页Journal of Clinical and Pathological Research

摘　　要：目的:中肾管肿瘤是一种罕见的肿瘤,本研究观察中肾管肿瘤的临床病理学特征,旨在提高对该肿瘤的认知水平,减少漏诊及误诊。方法:回顾性分析3例中肾管肿瘤的临床病理特征,行HE染色、免疫组织化学染色及过碘酸希夫染色,并复习其相关文献。结果:3例中肾管肿瘤病例均为女性,年龄分别为25、42、54岁,肿瘤分别位于左侧阔韧带、右侧阔韧带及右输卵管系膜,镜下肿瘤细胞呈紧密排列的管状及弥漫实性的片状分布,灶区见筛状结构,管状结构周围可见红染的基底膜样物质(过碘酸希夫染色阳性)。肿瘤细胞形态温和,核分裂象罕见。实性区瘤细胞呈卵圆形、多边形或胖梭形;小管状结构排列密集,管腔上皮细胞呈立方状,胞质较透明,核圆,位于基底部。免疫组织化学染色示:广谱细胞角蛋白(cytokeratin-pan,CK-pan)、波形蛋白(vimentin)、抑制素-A(inhibin-A)、钙网膜蛋白(calretinin)均为阳性,白细胞分化抗原10(cluster of differentiation 10,CD10)为部分阳性;上皮膜抗原(epithelial membrane antigen,EMA)、雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、配对盒基因8(paired box gene-8,PAX-8)、鸟嘌呤腺嘌呤胸腺嘧啶序列结合蛋白-3(guanine adenine thymine adenine sequence-binding protein-3,GATA-3)、类固醇生成因子-1(steroidogenic factor-1,SF-1)均为阴性。结论:中肾管肿瘤是一种具有低度恶性潜能的肿瘤,手术切除后需长期密切随访。Objective:Mesonephric duct tumor is a rare tumor.This study aims to observe the clinicopathological characteristics of mesonephric duct tumors and to enhance awareness of this tumor and reduce misdiagnosis and missed diagnoses.Methods:A retrospective analysis of the clinicopathological features of 3 mesonephric duct tumors was conducted,including HE staining,immunohistochemical staining,and periodic acid-Schiff staining.A review of relevant literature and recent advancements was also performed.Results:All three cases of mesonephric duct tumors occurred in female patients aged 25,42,and 54 years,respectively.The tumors were located in the left broad ligament,right broad ligament,and right mesosalpinx.Microscopically,the tumor cells were tightly arranged in tubular and solid sheet-like patterns,with focal areas showing cribriform structures.A basement membrane-like eosinophilic substance(positive for periodic acid Schiff staining)was observed around the tubular structures.The tumor cells exhibited mild cytological atypia,with rare mitotic figures.In the solid areas,tumor cells appeared oval,polygonal,or plump spindle-shaped,with the small tubular structures were densely arranged,with cuboidal epithelial cells having clear cytoplasm and round,basally located nuclei.Immunohistochemistry,the tumor cells were positive for cytokeratin-pan(CK-pan),vimentin,inhibin-A,and calretinin,with focal positivity for cluster of differentiation 10(CD 10).They were negative for epithelial membrane antigen(EMA),estrogen receptor(ER),progesterone receptor(PR),paired box gene-8(PAX-8),guanine adenine thymine adenine sequence-binding protein-3(GATA-3),and steroidogenic factor-1(SF-1).Conclusion:Mesonephric duct tumors are neoplasms with low malignant potential.Long term follow-up is necessary after surgical resection.

关 键 词：中肾管肿瘤 临床病理分析 免疫组织化学 低度恶性潜能 过碘酸希夫染色 

分 类 号：R737.11[医药卫生—肿瘤]