Yan Fengcai, Shi Feng, Li Xinbao, Yu Chunkai, Lin Yulin, Li Yan, Jin Mulan
Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
Cancer Manag Res. 2020 Aug 21;12:7569-7578. doi: 10.2147/CMAR.S264474. eCollection 2020.
This study aims to demonstrate clinicopathological characteristics and immunohistopathological phenotypes of pseudomyxoma peritonei (PMP) originated from ovaries.
The primary origin of PMP was explored by reviewing H&E sections retrospectively and performing a series of immunohistochemical staining on CK7, CK20, CDX2, CEA, Villin, SATB2, CA125, ER, PR, and MUC.
Among 310 PMP patients, a few originated from extra-appendix, whereas eight cases were of ovarian origin (2.6%), including three teratoma-associated ovarian mucinous tumors and five primary ovarian mucinous tumors with spontaneous or iatrogenic rupture, respectively. Most peritoneal metastases were acellular mucin or low-grade mucinous carcinoma peritonei (6/8, 75%), while the rest were high-grade mucinous carcinoma peritonei (2/8, 25%). Tumors were positive for CK20, CDX2, CEA, and Villin. SATB2 was specifically diffuse positive in teratoma-associated ovarian mucinous tumors, and negative in primary ovarian mucinous tumors. Differential expression of MUC was observed in these tumors.
PMP of ovarian origin is extremely rare. The precise diagnosis requires serial sections of the appendix or suspicious tissue to exclude appendiceal mucinous neoplasms, as well as comprehensive analysis of clinical features, surgical findings, histopathological characteristics, and immunohistochemistry on specific biomarkers.
本研究旨在阐述源自卵巢的腹膜假黏液瘤(PMP)的临床病理特征及免疫组织病理表型。
通过回顾性观察苏木精-伊红(H&E)切片,并对细胞角蛋白7(CK7)、细胞角蛋白20(CK20)、尾型同源盒转录因子2(CDX2)、癌胚抗原(CEA)、绒毛蛋白(Villin)、特殊AT富含序列结合蛋白2(SATB2)、癌抗原125(CA125)、雌激素受体(ER)、孕激素受体(PR)和黏蛋白(MUC)进行一系列免疫组织化学染色,以探究PMP的原发起源。
在310例PMP患者中,少数起源于阑尾外,而8例起源于卵巢(2.6%),分别包括3例与畸胎瘤相关的卵巢黏液性肿瘤和5例原发性卵巢黏液性肿瘤伴自发或医源性破裂。大多数腹膜转移灶为无细胞黏液或低级别腹膜黏液癌(6/8,75%),其余为高级别腹膜黏液癌(2/8,25%)。肿瘤CK20、CDX2、CEA和Villin呈阳性。SATB2在与畸胎瘤相关的卵巢黏液性肿瘤中呈特异性弥漫阳性,在原发性卵巢黏液性肿瘤中呈阴性。这些肿瘤中观察到MUC的差异表达。
卵巢起源的PMP极为罕见。准确诊断需要对阑尾或可疑组织进行连续切片以排除阑尾黏液性肿瘤,以及综合分析临床特征、手术发现、组织病理学特征和特定生物标志物的免疫组织化学结果。