Gilks C B, Bell D A, Scully R E
Department of Pathology, University of British Columbia, Vancouver, Canada.
Int J Gynecol Pathol. 1990;9(2):110-21. doi: 10.1097/00004347-199004000-00002.
We report 11 cases of serous psammocarcinoma, a rare variant of serous carcinoma characterized by massive psammoma body formation and low-grade cytological features. The patients ranged in age from 36 to 76 (mean of 57) years. The tumors were stage three in every case (three stage IIIA, seven stage IIIB, and one stage IIIC). Eight of the patients had ovarian psammocarcinomas with ovarian tumors measuring 5-22 (mean of 11) cm in diameter; the other three patients had primary peritoneal psammocarcinomas. The surfaces of the ovarian tumors were smooth and intact in seven of eight ovarian psammocarcinomas. Cysts were present in six of eight ovarian tumors, and the solid portions were typically gritty or granular. Necrosis was not seen. Microscopically there was destructive invasion of ovarian stroma or vascular invasion in the ovarian tumors; the extraovarian tumor implants were invasive of intraperitoneal viscera in five cases. The epithelium was arranged in small nests with no areas of solid epithelial proliferation, and at least 75% of the epithelial nests were associated with psammoma body formation. No more than moderate nuclear atypicality was identified in any case. No mitotic figures were found in 10 of the tumors, with a single mitotic figure identified in the other tumor. Follow-up data for more than 1 year was available for six patients, with two patients lost to follow-up and three patients followed without evidence of recurrence for less than 1 year. One patient died of tumor 6 1/2 years after presentation, and five patients were alive without evidence of recurrent tumor 3-10 (mean of 8.3) years after presentation. Although based on a small number of cases, these data suggest that the clinical behavior of psammocarcinoma more closely resembles that of borderline serous tumors than of serous carcinomas of the usual type, following a protracted course and being associated with a relatively favorable prognosis.
我们报告了11例浆液性砂粒体癌，这是一种罕见的浆液性癌变体，其特征为大量砂粒体形成和低级别细胞学特征。患者年龄在36至76岁之间（平均57岁）。所有病例的肿瘤均为三期（3例IIIA期，7例IIIB期，1例IIIC期）。8例患者患有卵巢浆液性砂粒体癌，卵巢肿瘤直径为5至22厘米（平均11厘米）；另外3例患者患有原发性腹膜浆液性砂粒体癌。8例卵巢浆液性砂粒体癌中的7例，其卵巢肿瘤表面光滑完整。8例卵巢肿瘤中有6例存在囊肿，实性部分通常质地粗糙或呈颗粒状。未见坏死。显微镜下，卵巢肿瘤中有卵巢间质的破坏性浸润或血管浸润；5例卵巢外肿瘤种植灶侵犯了腹腔内脏器。上皮呈小巢状排列，无实性上皮增殖区域，且至少75%的上皮巢与砂粒体形成相关。所有病例中均未发现超过中度的核异型性。10例肿瘤中未发现有丝分裂象，另一例肿瘤中发现1个有丝分裂象。6例患者有超过1年的随访数据，2例患者失访，3例患者随访时间不足1年且无复发证据。1例患者在就诊后6年半死于肿瘤，5例患者在就诊后3至10年（平均8.3年）存活且无肿瘤复发证据。尽管基于少数病例，但这些数据表明，砂粒体癌的临床行为更类似于交界性浆液性肿瘤，而非普通类型的浆液性癌，病程迁延，预后相对较好。
