Mulvany N J, Riley C B
Department of Anatomical Pathology, Royal Women's Hospital, Melbourne, Australia.
Pathology. 1997 Nov;29(4):348-53. doi: 10.1080/00313029700169295.
We reviewed the clinical, pathological and immunohistochemical features of six unilocular cystic granulosa cell tumors (UCGs) of the ovary. The mean age of the patients was 46 years and the presenting features included abdominal distension, pain, urinary frequency, dyspareunia and amenorrhea. The tumors were unilateral, thin walled and consisted of a single large cavity with a smooth internal lining. The mean tumor-diameter was 10 cm and in all instances the UCGs were of adult histological type. The granulosa cells in six tumors demonstrated immunoreactivity for vimentin, five neoplasms showed reactivity for both alpha-inhibin and progesterone-receptor protein and four showed reactivity for smooth muscle actin. All tumors were nonimmunoreactive with antibodies to epithelial membrane antigen, beta-inhibin, estrogen-receptor protein, testosterone and s100 antigen. Only one of the three patients tested preoperatively had an elevated serum inhibin concentration and this returned to normal six weeks post-operatively. We conclude that UCGs are distinguished by the infrequency of diagnostic serum tumor markers and clinically evident endocrine activity. Correct diagnosis is dependent on histological examination and the finding of a monotonous population of cells, a trabecular growth pattern, nuclear grooves, low mitotic activity and an immunohistochemical profile compatible with granulosa cell tumors.
我们回顾了6例卵巢单房性囊性颗粒细胞瘤（UCG）的临床、病理及免疫组化特征。患者的平均年龄为46岁，临床表现包括腹胀、疼痛、尿频、性交困难及闭经。肿瘤均为单侧，壁薄，由单个大腔构成，内衬光滑。肿瘤平均直径为10 cm，所有病例的UCG均为成人组织学类型。6例肿瘤中的颗粒细胞波形蛋白免疫反应阳性，5例肿瘤α抑制素和孕激素受体蛋白反应阳性，4例平滑肌肌动蛋白反应阳性。所有肿瘤上皮膜抗原、β抑制素、雌激素受体蛋白、睾酮及s100抗原抗体免疫反应均为阴性。术前检测的3例患者中仅1例血清抑制素浓度升高，术后6周恢复正常。我们得出结论，UCG的特点是诊断性血清肿瘤标志物少见且临床内分泌活动不明显。正确诊断依赖于组织学检查以及发现单一的细胞群、小梁状生长模式、核沟、低有丝分裂活性以及与颗粒细胞瘤相符的免疫组化特征。
