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[混合性卵巢生殖细胞肿瘤:成人胚胎性癌及伴滋养层细胞的无性细胞瘤]

[Mixed ovarian germinal neoplasia: adult embryonal carcinoma and dysgerminoma with trophoblasts].

作者信息

Martinazzi M, Bertoli G, Crivelli F, Zampatti C, Bersiga A

出版信息

Pathologica. 1989 Sep-Oct;81(1075):537-42.

PMID:2641155
Abstract

Malignant mixed germ cell tumor of the ovary: embryonal carcinoma and dysgerminoma with trophoblastic cells. A case of ovarian neoplasia in a 19-years-old woman is described showing mixed germ cell tumor patterns. The main component is a solid embryonal carcinoma with mainly syncytial-like, highly anaplastic cells, displaying diffuse CK-immunoreactivities and scattered PLAP-positive cells. Many CK- and beta-HCG-positive syncytiotrophoblastic and intermediate trophoblastic cells are present. A second component is a dysgerminoma with lymphoid stroma and diffuse PLAP-cytomembrane immunoreactivities: rare cells, to be identified as intermediate trophoblast cells, are CK- and strongly beta-HCG-positive. Many syncytiotrophoblastic cells with a brisk CK- and beta-HCG-positivities are also noted. The embryonal carcinoma component is metastasized to the controlateral ovary, uterus and omentum. A complete immunohistochemical analysis is recommended to properly diagnose germ cell neoplasias of the ovary both for descriptive and prognostic-therapeutic purposes. The very rare presence in the same ovarian tumor of mixed patterns as adult embryonal carcinoma and dysgerminoma with trophoblastic cells, is stressed.

摘要

卵巢恶性混合性生殖细胞肿瘤

胚胎性癌和伴有滋养层细胞的无性细胞瘤。描述了一名19岁女性的卵巢肿瘤病例,显示出混合性生殖细胞肿瘤模式。主要成分是实性胚胎性癌,主要由合体样、高度间变的细胞组成,显示弥漫性细胞角蛋白免疫反应性和散在的胎盘碱性磷酸酶阳性细胞。存在许多细胞角蛋白和β-人绒毛膜促性腺激素阳性的合体滋养层细胞和中间滋养层细胞。第二个成分是伴有淋巴样间质和弥漫性胎盘碱性磷酸酶细胞膜免疫反应性的无性细胞瘤:少数细胞,被鉴定为中间滋养层细胞,细胞角蛋白和强β-人绒毛膜促性腺激素阳性。也注意到许多细胞角蛋白和β-人绒毛膜促性腺激素阳性活跃的合体滋养层细胞。胚胎性癌成分转移至对侧卵巢、子宫和大网膜。为了描述和预后治疗目的,建议进行完整的免疫组织化学分析以正确诊断卵巢生殖细胞肿瘤。强调了在同一卵巢肿瘤中极罕见地出现成人胚胎性癌和伴有滋养层细胞的无性细胞瘤的混合模式。

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