Int J Gynecol Pathol. 2021 Mar 1;40(2):175-179. doi: 10.1097/PGP.0000000000000668.
High-grade serous carcinoma has a variety of different growth patterns, but is typically easily recognizable to pathologists and rarely confused with serous borderline tumors. We report a case of a 71-yr-old woman with a unilateral 5.1 cm ovarian cyst with small papillary projections on contrast-enhanced magnetic resonance imaging of the pelvis. Histologic examination showed a noninvasive papillary neoplasm with hierarchical branching and epithelial proliferation, and thus, at low magnification, bearing a striking resemblance to a serous borderline tumor. However, a more careful examination demonstrated high-grade cytologic features, nuclear pleomorphism, and abundant mitotic activity, suggestive of high-grade serous carcinoma. The morphology and immunohistochemical profile of this lesion is consistent with a rare, purely noninvasive growth pattern of high-grade serous carcinoma. This lesion represents the "far left" of the high-grade ovarian serous carcinoma morphologic spectrum and can mimic a serous borderline tumor.
高级别浆液性癌有多种不同的生长模式，但通常易于病理学家识别，很少与浆液性交界性肿瘤混淆。我们报告了一例 71 岁女性，盆腔增强磁共振成像显示单侧 5.1cm 卵巢囊肿，伴有小乳头状突起。组织学检查显示一种非浸润性乳头状肿瘤，具有分级分支和上皮增生，因此在低倍镜下与浆液性交界性肿瘤非常相似。然而，更仔细的检查显示出高级别的细胞学特征、核多形性和丰富的有丝分裂活性，提示为高级别浆液性癌。该病变的形态学和免疫组织化学特征与高级别浆液性癌罕见的纯非浸润性生长模式一致。该病变代表高级别卵巢浆液性癌形态学谱的“最左侧”，可模拟浆液性交界性肿瘤。
