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卵巢肝样癌的细胞病理学及临床病理特征。病例报告。

Cytopathologic and clinicopathologic features of ovarian hepatoid carcinoma. A case report.

作者信息

Watanabe Yoh, Umemoto Masahiko, Ueda Haruhiko, Nakai Hidekatsu, Hoshiai Hiroshi, Noda Kiichiro

机构信息

Department of Obstetrics and Gynecology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511, Japan.

出版信息

Acta Cytol. 2003 Jan-Feb;47(1):78-82. doi: 10.1159/000326479.

Abstract

BACKGROUND

Hepatoid carcinoma is a rare ovarian tumor and is thought to be a different histopathologic subtype from hepatoid-type yolk sac tumor based upon its pathologic features. However, the cytopathologic characteristics of ovarian hepatoid carcinoma (OHC) have not been reported previously. We report the clinicopathologic and cytopathologic features and immunoreactivity of a case of OHC.

CASE

A 36-year-old woman presented to our department with lower abdominal pain. A left ovarian tumor was found on pelvic examination, magnetic resonance imaging and computed tomography. The tumor was diagnosed as a hepatoid carcinoma of the left ovary based upon the histopathology of the surgically resected specimen. Cytopathologic specimens from a tumor touch preparation of the tumor exhibited pleomorphic tumor cells with abundant cytoplasm. The nuclei contained rough, granular chromatin and large, prominent nucleoli. Several tumor cells were multinucleated. Tumor cells were immunoreactive for alpha-fetoprotein (AFP). Hematoxylin and eosin staining revealed that the tumor cells were in a sinusoidal pattern resembling hepatocellular carcinoma without any glandular formation. The tumor cells were negative for human chorionic gonadotropin while positive for AFP, alpha-1-antitripsin, CA-125 and carcinoembryonic antigen.

CONCLUSION

Cytopathologic examination is of considerable aid in the diagnosis of OHC since cytopathologic preparations highlight the characteristic cell pleomorphism.

摘要

背景

肝样癌是一种罕见的卵巢肿瘤,基于其病理特征,被认为是与肝样型卵黄囊瘤不同的组织病理学亚型。然而,卵巢肝样癌(OHC)的细胞病理学特征此前尚未见报道。我们报告1例OHC的临床病理、细胞病理特征及免疫反应性。

病例

一名36岁女性因下腹部疼痛就诊于我科。盆腔检查、磁共振成像和计算机断层扫描发现左侧卵巢肿瘤。根据手术切除标本的组织病理学,该肿瘤被诊断为左侧卵巢肝样癌。肿瘤触片制备的细胞病理学标本显示肿瘤细胞多形性,胞质丰富。细胞核含有粗糙的颗粒状染色质和大而明显的核仁。几个肿瘤细胞为多核。肿瘤细胞对甲胎蛋白(AFP)呈免疫反应性。苏木精和伊红染色显示肿瘤细胞呈类似肝细胞癌的窦状模式,无任何腺管形成。肿瘤细胞对人绒毛膜促性腺激素呈阴性,而对AFP、α1抗胰蛋白酶、CA-125和癌胚抗原呈阳性。

结论

细胞病理学检查对OHC的诊断有很大帮助,因为细胞病理学标本突出了特征性的细胞多形性。

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