Hayes M C, Scully R E
Department of Pathology, Harvard Medical School, Boston, Massachusetts.
Am J Surg Pathol. 1987 Nov;11(11):835-45. doi: 10.1097/00000478-198711000-00002.
The clinical and pathological features of 63 steroid cell tumors, not otherwise specified, were reviewed. The patients ranged in age from 2 1/2 to 80 years. The most common initial manifestation was virilization (41%); four patients had estrogenic manifestations, and four had hypercortisolemia with Cushing's syndrome. The tumors, 6% of which were bilateral, ranged from 1.2 to 45 cm in greatest dimension. Microscopic examination revealed two types of cells, which had overlapping features: those with abundant eosinophilic cytoplasm and those with vacuolated cytoplasm. Fat stains were positive in 75% of the 16 cases in which they were performed. Follow-up data ranging from 1 to 19 years (average 5.2 years) in duration were available for 50 patients. In 24 cases, the tumor was designated probably benign (no evidence of spread beyond the ovary within 3 or more years postoperatively). In 18 patients, the tumor was clinically malignant. The best pathological correlates of malignant behavior were: the presence of two or more mitotic figures per 10 high power fields (92% malignant); necrosis (86% malignant); a diameter of 7 cm or greater (78% malignant); hemorrhage (77% malignant); and grade 2 or 3 nuclear atypia (64% malignant).
回顾了63例未另行分类的类固醇细胞瘤的临床和病理特征。患者年龄从2.5岁至80岁不等。最常见的初始表现为男性化（41%）；4例有雌激素表现，4例有高皮质醇血症伴库欣综合征。肿瘤最大直径为1.2至45 cm，其中6%为双侧性。显微镜检查发现两种细胞，其特征有重叠：一种细胞质丰富且嗜酸性，另一种细胞质有空泡。在进行脂肪染色的16例病例中，75%呈阳性。50例患者有随访数据，随访时间为1至19年（平均5.2年）。24例肿瘤被判定可能为良性（术后3年或更长时间内无卵巢外扩散证据）。18例患者的肿瘤临床诊断为恶性。与恶性行为最佳的病理相关因素为：每10个高倍视野有两个或更多有丝分裂象（92%为恶性）；坏死（86%为恶性）；直径7 cm或更大（78%为恶性）；出血（77%为恶性）；以及2级或3级核异型性（64%为恶性）。
