Dickersin G R, Scully R E
Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston 02114, USA.
Ultrastruct Pathol. 1998 May-Jun;22(3):199-226. doi: 10.3109/01913129809033472.
Small cell tumors of the ovary are uncommon but represent an important group to recognize in the differential diagnosis of primary and metastatic ovarian neoplasms. In some cases the correct diagnosis cannot be confidently made on the basis of clinical setting, routine light microscopy, and immunohistochemistry, and electron microscopy may be supportive or definitive in establishing cell type. The cell type is often important in choosing optimal therapy and in predicting prognosis. The authors performed electron microscopy on a moderate number of ovarian small cell tumors and here describe and illustrate the diagnostic features of representative examples of various types. The ultrastructural features of the metastatic tumors, such as embryonal rhabdomyosarcoma, neuroblastoma, and melanoma, are identical to those of their respective primary tumors, are well known, and usually pose no problem in diagnosis. On the other hand, the ultrastructural features of some primary ovarian small cell tumors may present a more difficult differential diagnosis, because they have features that are subtle and/or in common. Exemplary of tumors in this category are diffuse adult granulosa cell tumor, endometrial stromal sarcoma, and small cell carcinomas of the hypercalcemic and pulmonary (oat cell) types. Distinguishing among them may be difficult but is possible, and electron microscopy may be a valuable supplement to the diagnostic information obtained from the clinical presentation, light microscopy, immunohistochemistry and, in some tumors, cytometric analysis of these neoplasms.
卵巢小细胞肿瘤并不常见，但在原发性和转移性卵巢肿瘤的鉴别诊断中是需要识别的重要肿瘤类型。在某些情况下，仅依据临床症状、常规光学显微镜检查和免疫组织化学检查无法确切做出正确诊断，而电子显微镜检查对于确定细胞类型可能有辅助作用或具有决定性意义。细胞类型在选择最佳治疗方案和预测预后方面通常很重要。作者对一定数量的卵巢小细胞肿瘤进行了电子显微镜检查，并在此描述和展示了各种类型代表性病例的诊断特征。转移性肿瘤，如胚胎性横纹肌肉瘤、神经母细胞瘤和黑色素瘤的超微结构特征与其各自的原发性肿瘤相同，这些特征是众所周知的，通常在诊断中不会造成问题。另一方面，一些原发性卵巢小细胞肿瘤的超微结构特征可能会带来更困难的鉴别诊断，因为它们的特征较为细微和/或具有共性。这类肿瘤的典型例子包括弥漫性成人颗粒细胞瘤、子宫内膜间质肉瘤以及高钙血症型和肺型（燕麦细胞型）小细胞癌。区分它们可能很困难，但却是可行的，电子显微镜检查可能是对从临床表现、光学显微镜检查、免疫组织化学检查以及某些肿瘤的细胞计量分析中获得的诊断信息的有价值补充。
