CAJ | 학술논문

目的观察睾丸原发性神经内分泌癌的组织学、免疫表型及影像学特点，探讨其临床病理学特征、诊断及鉴别诊断。方法运用组织学、免疫组织化学技术对1例睾丸原发性神经内分泌癌进行光镜观察及免疫标记，并结合相关文献对其临床表现、影像学、组织形态和免疫组化特点及治疗和预后等进行综合分析。结果患者为52岁老年男性，肿瘤病理组织学表现为瘤细胞大小较一致，以梁状和岛状排列为主；瘤细胞呈多角形，胞质中度嗜酸性，核染色质细颗粒状。免疫组化染色示：瘤细胞CK （＋）、CD56（＋）、Syn （＋）、CgA（＋），Inhibin（-）、PLAP（-）、AFP（-）。结论原发于睾丸的神经内分泌癌非常罕见，通常不伴有类癌综合征。免疫组化染色有助于该肿瘤的诊断，鉴别诊断包括转移性神经内分泌癌、睾丸畸胎瘤合并类癌、精原细胞瘤、支持细胞瘤等，多数肿瘤可以通过手术切除治愈。
목적관찰고환원발성신경내분비암적조직학、면역표형급영상학특점，탐토기림상병이학특정、진단급감별진단。방법운용조직학、면역조직화학기술대1례고환원발성신경내분비암진행광경관찰급면역표기，병결합상관문헌대기림상표현、영상학、조직형태화면역조화특점급치료화예후등진행종합분석。결과환자위52세노년남성，종류병리조직학표현위류세포대소교일치，이량상화도상배렬위주；류세포정다각형，포질중도기산성，핵염색질세과립상。면역조화염색시：류세포CK （＋）、CD56（＋）、Syn （＋）、CgA（＋），Inhibin（-）、PLAP（-）、AFP（-）。결론원발우고환적신경내분비암비상한견，통상불반유유암종합정。면역조화염색유조우해종류적진단，감별진단포괄전이성신경내분비암、고환기태류합병유암、정원세포류、지지세포류등，다수종류가이통과수술절제치유。
Objective To investigate the clinicopathological characteristics and differential diagnosis of the primary neuroendocrine carcinoma of the testes .Methods We studied a case of the primary neuroendocrine carcinoma of the testes by light microscopy and immunohistochemistry ,reviewed relevant literature ,and analyzed the clinical ,morphological and immunohistochemical features ,treatment and prognosis of the tumor .Results The patient was a 52 years old man.Pathohistologically,the tumor was characterized by a pattern of island and bearn shape ,the most of the tumor cells were all consistent .The tumor cells were polygon and moderate eosinophilic cytoplasm .The nuclear chromatin was fine granular .Immunohistochemical staing showed that the cells was positive for CK ,CD56, Syn,cgA.The tumor cells were negative for inhinbin , PLAP, AFP.Conclusion The primary neuroendocrine carcinoma of the testes is a very rare tumor with imaging features .The diagnosis is based on immunohistochemical staining.It should be differenriated from other metastatic neuroendocrine carcinoma ,the teratomas with the carcinoid , the seminoma,the sertoli cell tumor.For the treatment of the most of primary neuroendocrine carcinoma ,surgical resection combined with other therapies has a good prognosis .