Biscotti C V, Hart W R
Department of Pathology, Cleveland Clinic Foundation, OH 44106.
Arch Pathol Lab Med. 1989 Jan;113(1):40-6.
The clinical and pathologic features of 13 cases of juvenile granulosa cell tumor were studied. Patients' ages ranged from 6 months to 56 years (median age, 17 years). Only one patient was postmenopausal. Three premenarchal patients had isosexual development. Five of seven postmenarchal patients had menstrual abnormalities, and two patients demonstrated virilization. Ascites was present in two patients. All patients had unilateral stage I tumors, ranging from 2.5 to 24.5 cm in greatest dimension (mean greatest dimension, 12.2 cm). Characteristic histologic features included nodular architecture, follicle formation, abundant interstitial and intrafollicular acid mucopolysaccharide-rich fluid, irregular microcysts, individual cell necrosis, and high mitotic activity (mean activity, 11 mitotic figures per ten high-power fields). The interstitial mucinous fluid consisted predominantly of hyaluronic acid. Immunohistochemical staining in five cases showed prominent positivity for vimentin (four cases), isolated cytokeratin AE1/3-positive cells (two cases), and nonreactivity for carcinoembryonic antigen and milk fat globule-2. Ultrastructurally, epithelial cells that resembled granulosa cells of the nonneoplastic preovulatory follicle and occasional cells with steroidogenic organelles were also found. Follow-up of ten patients revealed no tumor recurrences from six months to 33 years (mean, 9.5 years) after operation.
对13例青少年颗粒细胞瘤的临床和病理特征进行了研究。患者年龄从6个月至56岁不等（中位年龄17岁）。仅1例患者为绝经后。3例青春期前患者有同性性发育。7例青春期后患者中有5例有月经异常，2例表现为男性化。2例患者出现腹水。所有患者均为单侧Ⅰ期肿瘤，最大直径为2.5至24.5 cm（平均最大直径12.2 cm）。特征性组织学特征包括结节状结构、卵泡形成、丰富的间质和卵泡内富含酸性粘多糖的液体、不规则微囊肿、单个细胞坏死以及高有丝分裂活性（平均活性为每十个高倍视野有11个有丝分裂象）。间质粘液性液体主要由透明质酸组成。5例患者的免疫组化染色显示波形蛋白呈显著阳性（4例），孤立的细胞角蛋白AE1/3阳性细胞（2例），癌胚抗原和乳脂肪球-2无反应。超微结构上，还发现了类似于非肿瘤性排卵前卵泡颗粒细胞的上皮细胞以及偶尔带有类固醇生成细胞器的细胞。对10例患者的随访显示，术后6个月至33年（平均9.5年）无肿瘤复发。
