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[输卵管原发性黏液性腺病变:14例临床病理分析]

[Primary mucinous gland lesions of fallopian tube: a clinicopathological analysis of fourteen cases].

作者信息

Zhang L L, Xu Y, Ji S T, Ning Y, Gu W Y

机构信息

Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200090, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2024 Jun 8;53(6):546-551. doi: 10.3760/cma.j.cn112151-20240325-00194.

Abstract

To investigate the clinical and pathological characteristics of primary mucinous gland lesions of the fallopian tubes. The clinical data, pathomorphological characteristics and immunophenotype of 14 cases of primary mucinous gland lesions of the fallopian tube diagnosed at Obstetrics and Gynecology Hospital of Fudan University from 2015 to 2023 were analyzed retrospectively. In addition, a comprehensive review of relevant literature was conducted. The age of 14 patients ranged from 53 to 83 years, with an average of 65 years. Among them, 13 cases exhibited unilateral involvement while one case showed bilateral presentation. Nine cases were mucinous metaplasia of the fallopian tube, four cases were invasive mucinous adenocarcinoma and one case was mucinous carcinoma in situ. Morphologically, mucinous metaplasia of the fallopian tube was focal, with or without inflammation. The cells of mucinous adenocarcinoma or mucinous carcinoma in situ exhibited characteristics indicative of gastrointestinal differentiation. Immunohistochemical analysis revealed diffuse positive expression of CK7, and negative expression of SATB2. CDX2 demonstrated positive staining in two cases. One case exhibited diffuse and strongly positive mutant expression of p53, whereas the remaining cases displayed wild-type expression. MUC6 showed diffuse or focally positive staining in mucinous gland lesions characterized by gastric differentiation. Some cases of mucinous adenocarcinoma of fallopian tube were subject to AB-PAS staining, resulting in red to purple cytoplasmic staining. Primary mucinous lesions of the fallopian tube are exceedingly uncommon. All cases of mucinous adenocarcinoma of fallopian tubes in this study exhibit the morphology and immunohistochemical characteristics of gastrointestinal differentiation. Mucinous metaplasia of the fallopian tube is a benign lesion of incidental finding, which is closely related to inflammation or gastric differentiation. Mucinous lesions of cervix, ovary and digestive tract are excluded in all patients, confirming the independent existence of mucinous lesions within fallopian tubes.

摘要

探讨输卵管原发性黏液性腺病变的临床及病理特征。回顾性分析2015年至2023年在复旦大学附属妇产科医院诊断的14例输卵管原发性黏液性腺病变的临床资料、病理形态学特征及免疫表型。此外,还对相关文献进行了全面综述。14例患者年龄在53岁至83岁之间,平均年龄为65岁。其中,13例为单侧受累,1例为双侧受累。9例为输卵管黏液化生,4例为浸润性黏液腺癌,1例为原位黏液癌。形态学上,输卵管黏液化生呈局灶性,可伴有或不伴有炎症。黏液腺癌或原位黏液癌的细胞表现出胃肠道分化的特征。免疫组化分析显示CK7弥漫性阳性表达,SATB2阴性表达。CDX2在2例中呈阳性染色。1例p53呈弥漫性强阳性突变表达,其余病例呈野生型表达。MUC6在以胃分化为特征的黏液性腺病变中呈弥漫性或局灶性阳性染色。部分输卵管黏液腺癌病例行AB-PAS染色,细胞质呈红至紫色染色。输卵管原发性黏液性病变极为罕见。本研究中所有输卵管黏液腺癌病例均表现出胃肠道分化的形态学和免疫组化特征。输卵管黏液化生是一种偶然发现的良性病变,与炎症或胃分化密切相关。所有患者均排除宫颈、卵巢及消化道的黏液性病变,证实输卵管内黏液性病变独立存在。

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