CAJ | 학술논문

目的探讨睾丸幼年性黄色肉芽肿的临床及病理特征. 方法回顾性分析2013年5月收治1例睾丸幼年性黄色肉芽肿患者的诊治情况.患儿6个月,因发现阴囊内肿物2周入院.查体:左侧睾丸大小约2.0 cm×2.0 cm,质地硬,透光试验阴性.甲胎蛋白37.60 μg/L,人绒毛膜促性腺激素＜2.0 IU/L.胸部X线片正常.B超检查提示左睾丸内不均质团块,左侧精索增粗,血供丰富.术前诊断为左侧睾丸肿瘤. 结果行经腹股沟切口手术,术中见左侧精索明显增粗,睾丸弥漫性肿大,质地硬,与正常睾丸组织界限不清,并浸润附睾,附睾头及体部变硬.行高位精索切断睾丸切除术.组织学检查见大量单核细胞、泡沫细胞及炎症细胞(中性粒细胞、嗜酸性粒细胞及淋巴细胞),局灶伴脓肿形成.未见典型的Touton巨细胞.免疫组化显示CD68、CD163阳性,而CD1a阴性.病理诊断为左睾丸幼年性黄色肉芽肿.术后随访10个月未见肿瘤复发. 结论睾丸幼年性黄色肉芽肿是一种罕见的睾丸良性疾病,临床表现缺乏特异性,组织学特点和免疫组化标志物是诊断该病的主要依据,需与淋巴瘤、白血病及其他睾丸肿瘤相鉴别.
목적 탐토고환유년성황색육아종적림상급병리특정. 방법 회고성분석2013년5월수치1례고환유년성황색육아종환자적진치정황.환인6개월,인발현음낭내종물2주입원.사체:좌측고환대소약2.0 cm×2.0 cm,질지경,투광시험음성.갑태단백37.60 μg/L,인융모막촉성선격소＜2.0 IU/L.흉부X선편정상.B초검사제시좌고환내불균질단괴,좌측정색증조,혈공봉부.술전진단위좌측고환종류. 결과 행경복고구절구수술,술중견좌측정색명현증조,고환미만성종대,질지경,여정상고환조직계한불청,병침윤부고,부고두급체부변경.행고위정색절단고환절제술.조직학검사견대량단핵세포、포말세포급염증세포(중성립세포、기산성립세포급림파세포),국조반농종형성.미견전형적Touton거세포.면역조화현시CD68、CD163양성,이CD1a음성.병리진단위좌고환유년성황색육아종.술후수방10개월미견종류복발. 결론 고환유년성황색육아종시일충한견적고환량성질병,림상표현결핍특이성,조직학특점화면역조화표지물시진단해병적주요의거,수여림파류、백혈병급기타고환종류상감별.
Objective To discuss the clinical and pathological features of the juvenile xanthogranuloma of testis.Methods A case of the juvenile xanthogranuloma of testis was reported.A 6-month-old boy presented with scrotal mass for 2 weeks before admission.Physical examination revealed that the left testis was hard with the size of 2.0 cm×2.0 cm and the serum alpha-fetoprotein was 37.60 μg/L.Chest X-ray and serum human chorionic gonadotropin investigations were normal.B-ultrasound examination showed a solid mass of uniform homogeneity in the left testis,with rich blood supply.Results The patient underwent operation after inguinal incision under general anaesthesia.During operation the left spermatic was augmented,and the mass was infiltrated into the whole testis and epididydis,and an inguinal orchiectomy was competed.Histopathological examination revealed that the lesion was intratesticular and involvement of the epididymis,predominantly occupied with an infiltrative pattern of by mononuclear cells,foamy cells and inflammatory cells (neutrophils,eosinophils,lymphocytes),without Touton giant cells.Immunohistochemical examination revealed positive for CD68 and CD163,and negative for CD1a.The pathological result was juvenile xanthogranuloma.During the follow-up period for 10 months,no recurrence was recorded.Conclusions Juvenile xanthogranuloma of the testis is an extremely rare benign disease lack of special feature in clinical manifestation.The diagnosis mainly depends on histological features and special markers in immunohistochemistry.Differential diagnosis should be made among leukemia,lymphoma and other distinctive neoplasms.