Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA.
Diagn Cytopathol. 2021 Jun;49(6):E207-E213. doi: 10.1002/dc.24675. Epub 2020 Dec 9.
Recently we encountered two cases with mesonephric features, mesonephric-like carcinoma (MLC) of the ovary, and female adnexal tumor of probable Wolffian origin (FATWO). They are thought to be related to mesonephric remnants (or Wolffian duct remnants). Herein we describe the cytohistolgical features, differential diagnoses, and potential pitfalls in diagnosis of these neoplasms. On cytological examination, the case of MLC showed tight 3-dimensional clusters of overlapping round cells, corresponding to solid growth pattern seen on histological examination. Tubular architecture and papillary formations composed of neoplastic cells of medium size with scant cytoplasm were readily identified. Intraluminal eosinophilic secretions were better seen on histological examination. Additionally, areas resembling features of papillary thyroid carcinoma were noted. Mitoses and apoptotic bodies were not identified on cytology but seen on histological sections. The neoplastic cells were positive for CK7, CD10, PAX-8, TTF-1, and GATA-3, and negative for ER, PR, and WT-1 immunostains. In contrast to MLC, cytological examination of FATWO showed smaller oval to spindle monotonous cells without mitotic figures. Some cells contained paranuclear vacuoles and were arranged individually or in loose cohesive clusters. Other cells were closely associated with pericellular hyalinized basement membrane-like material and they were arranged in cohesive clusters as well. On histological examination, similar to MLC, the FATWO had areas with thyroid-like features, such as, intraluminal eosinophilic secretions, paranuclear vacuoles, in the background of collagenous stroma. The neoplastic cells were positive for CK AE1/AE3, calretinin, WT-1, inhibin, and CD10, and negative for CK7, PAX-8, GATA-3, ER, PR, and C-kit immunostains.
最近我们遇到了两例具有中肾样特征的病例，卵巢中肾样癌（MLC）和可能来源于 Wolffian 导管的女性附件肿瘤（FATWO）。它们被认为与中肾残迹（或 Wolffian 导管残迹）有关。本文描述了这些肿瘤的细胞组织学特征、鉴别诊断和诊断中的潜在陷阱。在细胞学检查中，MLC 病例显示紧密的 3 维重叠圆形细胞簇，与组织学检查所见的实性生长模式相对应。管状结构和由中等大小、细胞质稀少的肿瘤细胞组成的乳头状形成很容易识别。组织学检查中可以更好地看到腔内嗜酸性分泌物。此外，还注意到类似于甲状腺乳头状癌特征的区域。细胞学检查中未发现有丝分裂和凋亡小体，但在组织切片中可见。肿瘤细胞 CK7、CD10、PAX-8、TTF-1 和 GATA-3 阳性，ER、PR 和 WT-1 免疫染色阴性。与 MLC 相反，FATWO 的细胞学检查显示较小的椭圆形至梭形单核单调细胞，无有丝分裂象。一些细胞含有核周空泡，呈单个或松散的黏附性簇状排列。其他细胞与细胞周围的玻璃样基底膜样物质密切相关，也呈黏附性簇状排列。在组织学检查中，FATWO 与 MLC 相似，具有甲状腺样特征的区域，如腔内嗜酸性分泌物、核周空泡，背景为胶原基质。肿瘤细胞 CK AE1/AE3、钙视网膜蛋白、WT-1、抑制素和 CD10 阳性，CK7、PAX-8、GATA-3、ER、PR 和 C-kit 免疫染色阴性。
