Eichhorn J H, Young R H, Scully R E
Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
Am J Surg Pathol. 1992 Oct;16(10):926-38. doi: 10.1097/00000478-199210000-00002.
Eleven primary ovarian tumors that resembled small cell carcinoma of the lung are reported. They occurred in women 28-85 (mean 59) years of age, most of whom presented with abdominal swelling. Six of the tumors were unilateral and five bilateral; seven had spread beyond the ovary. The tumors ranged from 4.5 to 26 (mean 13.5) cm in greatest dimension and were mostly solid, with a variable minor cystic component. Microscopic examination showed small to medium-sized round to spindle-shaped cells with scanty cytoplasm, hyperchromatic nuclei, and inconspicuous nucleoli growing in sheets, closely packed nests, and occasionally islands and trabeculae. A component of endometrioid carcinoma was present in four tumors, another tumor showed squamous differentiation, another contained a cyst lined by atypical mucinous cells, and two others were associated with a Brenner tumor. Argyrophil granules were present focally in two of six tumors appropriately stained. Immunohistochemical staining was performed in nine cases: in six there was staining of the small cell component for keratin, in five for epithelial membrane antigen, in seven for neuron-specific enolase, in two for chromogranin, and in one for Leu-7. Vimentin staining was not observed. Flow cytometry was performed on eight tumors: five were aneuploid and three diploid. Five of seven patients with long-term follow-up died of, or with, disease at 1-13 (mean 8) months, one died after an unknown interval, and one was alive at 7.5 years. Two other patients had recurrent or residual disease at 6 and 8 months.
报告了11例类似肺小细胞癌的原发性卵巢肿瘤。这些肿瘤发生于28 - 85岁（平均59岁）的女性，大多数患者表现为腹部肿胀。其中6例肿瘤为单侧，5例为双侧；7例已扩散至卵巢以外。肿瘤最大直径为4.5至26厘米（平均13.5厘米），大多为实性，伴有少量囊性成分。显微镜检查显示，肿瘤由小到中等大小的圆形至梭形细胞组成，细胞质稀少，核深染，核仁不明显，呈片状、紧密排列的巢状生长，偶尔呈岛状和小梁状。4例肿瘤中存在子宫内膜样癌成分，另1例肿瘤表现为鳞状分化，另1例含有由非典型黏液细胞衬覆的囊肿，还有2例与勃勒纳瘤相关。在6例经适当染色的肿瘤中，有2例局部存在嗜银颗粒。对9例进行了免疫组织化学染色：6例小细胞成分对角蛋白染色阳性，5例对上皮膜抗原染色阳性，7例对神经元特异性烯醇化酶染色阳性，2例对嗜铬粒蛋白染色阳性，1例对Leu - 7染色阳性。未观察到波形蛋白染色阳性。对8例肿瘤进行了流式细胞术检测：5例为非整倍体，3例为二倍体。7例长期随访患者中，5例在1至13个月（平均8个月）死于疾病或伴有疾病，1例在未知间隔后死亡，1例在7.5年时仍存活。另外2例患者在6个月和8个月时出现复发或残留疾病。
