Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Hum Pathol. 2012 Oct;43(10):1618-26. doi: 10.1016/j.humpath.2011.11.019. Epub 2012 Mar 19.
The nature of "piling up" proliferation of clear cells in müllerian mucinous/mixed borderline tumor has not been well characterized. The purpose of this study was to clarify whether or not such clear cells represent concomitant clear cell neoplasms. First, we carefully reviewed hematoxylin and eosin slides taken from 139 ovarian tumors diagnosed as clear cell carcinoma (112 cases) and müllerian mucinous/mixed borderline tumor (27 cases) to clarify (1) the frequency of piling-up clear cells in müllerian mucinous/mixed borderline tumor and (2) the frequency of the coexistence of typical clear cell carcinoma and müllerian mucinous/mixed borderline tumor. Second, we investigated the immunohistochemical expression of estrogen receptor, hepatocyte nuclear factor-1β, and glypican-3 in proliferating clear cells in both tumors. We identified piling-up clear cells in 56% of müllerian mucinous/mixed borderline tumors. Such clear cells lacked the severe nuclear atypia, complex branching, and dense hyalinized cores of typical clear cell carcinoma. We did not find coexistence of typical clear cell carcinoma and müllerian mucinous/mixed borderline tumor in any tumors. Piling-up clear cells and endocervical-like mucinous cells were positive for estrogen receptor but negative for hepatocyte nuclear factor-1β and glypican-3. Most clear cell carcinomas showed a hepatocyte nuclear factor-1β-positive/estrogen receptor-negative immunophenotype, and about half of them were glypican-3 positive. In conclusion, piling-up clear cells in müllerian mucinous/mixed borderline tumor do not represent concomitant clear cell neoplasms because clear cell carcinoma and müllerian mucinous/mixed borderline tumor hardly ever coexist and because such clear cells in both tumors are immunophenotypically distinct.
Müllerian 黏液性/混合交界性肿瘤中透明细胞的“堆积”增生的性质尚未得到很好的描述。本研究的目的是阐明这些透明细胞是否代表同时存在的透明细胞肿瘤。首先，我们仔细复习了 139 例卵巢肿瘤的苏木精和伊红切片，这些肿瘤被诊断为透明细胞癌（112 例）和 Müllerian 黏液性/混合交界性肿瘤（27 例），以明确（1）Müllerian 黏液性/混合交界性肿瘤中透明细胞堆积的频率，（2）典型透明细胞癌和 Müllerian 黏液性/混合交界性肿瘤同时存在的频率。其次，我们研究了两种肿瘤中增殖的透明细胞中雌激素受体、肝细胞核因子-1β 和聚糖-3 的免疫组织化学表达。我们在 56%的 Müllerian 黏液性/混合交界性肿瘤中发现了透明细胞堆积。这些透明细胞缺乏典型透明细胞癌的严重核异型性、复杂分支和密集的玻璃样核心。我们没有在任何肿瘤中发现典型透明细胞癌和 Müllerian 黏液性/混合交界性肿瘤的同时存在。堆积的透明细胞和宫颈样黏液细胞对雌激素受体呈阳性，但对肝细胞核因子-1β 和聚糖-3 呈阴性。大多数透明细胞癌表现出肝细胞核因子-1β 阳性/雌激素受体阴性的免疫表型，约一半为聚糖-3 阳性。总之，Müllerian 黏液性/混合交界性肿瘤中的透明细胞堆积并不代表同时存在的透明细胞肿瘤，因为透明细胞癌和 Müllerian 黏液性/混合交界性肿瘤很少同时存在，而且两种肿瘤中的透明细胞在免疫表型上是不同的。
