卵巢室管膜瘤的肿瘤印片细胞学：一例报告

Komuro Y, Mikami M, Sakaiya N, Kurahashi T, Komiyama S, Tei C, Mukai M, Hirose T

Department of Obstetrics and Gynecology, National Saitama Hospital, Wako City, Saitama, Japan.

Cancer. 2001 Dec 15;92(12):3165-9. doi: 10.1002/1097-0142(20011215)92:12<3165::aid-cncr10111>3.0.co;2-y.

BACKGROUND

Ependymoma is a tumor that usually develops in the central nervous system and is extremely rare in the ovary. The first case of ovarian ependymoma was reported by Kleinman et al. (Kleinman GM, Young RH, Scully RE. Ependymoma of the ovary: report of three cases. Hum Pathol 1984;15:632-8.) in 1984, and only eight cases have been reported since then. Criteria for the histopathologic diagnosis of ependymoma are already established, but there has been no investigation of the cytologic diagnosis of ovarian ependymoma.

METHODS

An imprint cytologic specimen was obtained from a recurrent ovarian ependymoma. The imprint cytologic features were compared with the findings of histologic examination, immunostaining, and electron microscopy.

RESULTS

Imprint cytology revealed clusters of small cells with tapering cytoplasmic processes and a round nucleus. On the basis of these features, a neurogenic tumor could be included in the differential diagnosis. Furthermore, many rosette-like collections of cells that were suggestive of ependymal rosettes or perivascular pseudorosettes, characteristic of ependymoma, were found. The presence of ependymal rosettes and perivascular pseudorosettes also were confirmed by the histopathologic examination. Together with positive immunostaining for glial fibrillary acidic protein, this led to the diagnosis of ependymoma, which also was supported by the electron microscopic findings.

CONCLUSIONS

Careful observation of the imprint cytologic specimen of an ovarian ependymoma should reveal numerous rosette-like collections of cells that were suggestive of ependymal rosettes or perivascular pseudorosettes. In addition, if we remember that ependymoma can develop in the ovary and find cells with tapering processes that suggest a neurogenic tumor, it may be possible to detect histologic features characteristic of ependymoma by the imprint cytology. To our knowledge, this is the first report on the imprint cytologic diagnosis of ependymoma originating in the ovary.

背景

室管膜瘤是一种通常发生于中枢神经系统的肿瘤，在卵巢中极为罕见。1984年，克莱曼等人（Kleinman GM, Young RH, Scully RE. Ependymoma of the ovary: report of three cases. Hum Pathol 1984;15:632 - 8.）报道了首例卵巢室管膜瘤，自那时起仅有8例相关报道。室管膜瘤的组织病理学诊断标准已经确立，但尚无关于卵巢室管膜瘤细胞学诊断的研究。

方法

从一例复发性卵巢室管膜瘤获取印片细胞学标本。将印片细胞学特征与组织学检查、免疫染色及电子显微镜检查结果进行比较。

结果

印片细胞学显示小细胞簇，细胞具有逐渐变细的胞质突起和圆形细胞核。基于这些特征，神经源性肿瘤可纳入鉴别诊断。此外，发现了许多呈玫瑰花结样的细胞聚集，提示为室管膜瘤特有的室管膜玫瑰花结或血管周围假玫瑰花结。组织病理学检查也证实了室管膜玫瑰花结和血管周围假玫瑰花结的存在。结合胶质纤维酸性蛋白免疫染色阳性，这使得室管膜瘤的诊断得以确立，电子显微镜检查结果也支持这一诊断。

结论

仔细观察卵巢室管膜瘤的印片细胞学标本应能发现许多呈玫瑰花结样的细胞聚集，提示为室管膜玫瑰花结或血管周围假玫瑰花结。此外，如果我们记住室管膜瘤可发生于卵巢，并发现具有逐渐变细突起的细胞提示神经源性肿瘤，那么通过印片细胞学有可能检测到室管膜瘤的组织学特征。据我们所知，这是关于起源于卵巢的室管膜瘤印片细胞学诊断的首例报道。