浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2014年
12期
1076-1078
,共3页
无性细胞瘤%卵巢%临床病理学
無性細胞瘤%卵巢%臨床病理學
무성세포류%란소%림상병이학
Dysgerminoma%Ovarian%Clinical pathology
目的：探讨卵巢无性细胞瘤的临床病理特征、诊断及鉴别诊断。方法回顾性分析7例卵巢无性细胞瘤的临床病理资料。结果7例患者最常见的腹部症状及体征为腹部包块（6例，85.71%），腹水（5例，71.43%），腹痛（2例，28.57%）。实验室检查LDH升高4例，NSE升高4例，β-HCG升高2例，CA125升高2例，AFP升高1例；7例均为手术切除标本，均行术中冰冻切片检查，镜下表现为瘤细胞为大小一致的圆形、多角形细胞组成，胞质丰富淡染，瘤细胞排列成条索状、巢状、岛屿状，其间均可见纤维组织间隔分隔，间隔内见多少不一淋巴细胞浸润。免疫组化示肿瘤细胞PLAP、CD117、OCT4、NSE呈不同程度阳性。结论卵巢无性细胞瘤是一种少见的恶性生殖细胞肿瘤，其临床表现无特异性，易误诊，需结合临床表现及实验室检查，确诊需依赖病理学检查及免疫组化。该病多见于年轻女性，尤其对于需保留生殖功能的女性，术中冰冻检查的形态学鉴别诊断尤为重要。
目的：探討卵巢無性細胞瘤的臨床病理特徵、診斷及鑒彆診斷。方法迴顧性分析7例卵巢無性細胞瘤的臨床病理資料。結果7例患者最常見的腹部癥狀及體徵為腹部包塊（6例，85.71%），腹水（5例，71.43%），腹痛（2例，28.57%）。實驗室檢查LDH升高4例，NSE升高4例，β-HCG升高2例，CA125升高2例，AFP升高1例；7例均為手術切除標本，均行術中冰凍切片檢查，鏡下錶現為瘤細胞為大小一緻的圓形、多角形細胞組成，胞質豐富淡染，瘤細胞排列成條索狀、巢狀、島嶼狀，其間均可見纖維組織間隔分隔，間隔內見多少不一淋巴細胞浸潤。免疫組化示腫瘤細胞PLAP、CD117、OCT4、NSE呈不同程度暘性。結論卵巢無性細胞瘤是一種少見的噁性生殖細胞腫瘤，其臨床錶現無特異性，易誤診，需結閤臨床錶現及實驗室檢查，確診需依賴病理學檢查及免疫組化。該病多見于年輕女性，尤其對于需保留生殖功能的女性，術中冰凍檢查的形態學鑒彆診斷尤為重要。
목적：탐토란소무성세포류적림상병리특정、진단급감별진단。방법회고성분석7례란소무성세포류적림상병리자료。결과7례환자최상견적복부증상급체정위복부포괴（6례，85.71%），복수（5례，71.43%），복통（2례，28.57%）。실험실검사LDH승고4례，NSE승고4례，β-HCG승고2례，CA125승고2례，AFP승고1례；7례균위수술절제표본，균행술중빙동절편검사，경하표현위류세포위대소일치적원형、다각형세포조성，포질봉부담염，류세포배렬성조색상、소상、도서상，기간균가견섬유조직간격분격，간격내견다소불일림파세포침윤。면역조화시종류세포PLAP、CD117、OCT4、NSE정불동정도양성。결론란소무성세포류시일충소견적악성생식세포종류，기림상표현무특이성，역오진，수결합림상표현급실험실검사，학진수의뢰병이학검사급면역조화。해병다견우년경녀성，우기대우수보류생식공능적녀성，술중빙동검사적형태학감별진단우위중요。
Objective To investigate the clinicopathologic features,diagnosis and differential diagnosis of ovarian dys-germinoma. Methods The clinicopathological data of 7 cases of ovarian dysgerminoma were retrospectively analyzed. Results The abdominal symptoms and signs included abdominal mass(n=6), ascites(n=5) and abdominal pain(n=2). The laboratory tests showed elevated serum lactate dehydrogenase(LDH), neuronspecific enolase (NSE), chorionic gonadotropin (β-HCG), carbo-hydrate antigen 125 (CA125) and alpha fetoprotein (AFP) in 4,4, 2, 2 and 1 cases respectively. Al the cases underwent surgical excision of the ovary and frozen sections were made. Microscopical y,tumor cells were composed of uniform size circular, polyg-onal cells with rich and light- stain cytoplasm;tumor cells were ranged as cords,nests and islands and separated by fibrous belts which were thin and contained infiltrated lymphocytes. Immunohistochemistry showed different extent of positive stain of PLAP, CD117, OCT4 and NSE in tumor cells. Conclusion Ovarian dysgerminoma is a rare malignant germ celltumor with no specific clinical manifestations;the diagnosis depends on pathological examination and immunohistochemistry.
