發(fā)布時間：2018-05-21 04:28

  本文選題：卵巢腫瘤 + 小細(xì)胞癌��； 參考：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2015年05期

【摘要】：目的探討卵巢高鈣血癥型小細(xì)胞癌(ovarian small cell carcinoma hypercalcemic type,OSCCHT)伴急性腎功能不全的臨床病理學(xué)特征、診斷及鑒別診斷。方法回顧性分析1例OSCCHT伴急性腎臟功能不全患者的臨床資料、組織學(xué)形態(tài)、免疫表型、超微結(jié)構(gòu)等,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果患者女性,29歲。因無明顯誘因出現(xiàn)食欲不振伴明顯消瘦1個月余。實(shí)驗(yàn)室檢查示腎功能異常;影像學(xué)示盆腔腫塊,考慮附件來源。血液透析腎功能部分恢復(fù)后行手術(shù)。右側(cè)卵巢見一12 cm×10 cm×10 cm大小腫瘤,鏡下見瘤細(xì)胞呈彌漫實(shí)性分布,被纖維條索分割成多結(jié)節(jié)狀,部分細(xì)胞間可見小濾泡樣、假腺樣結(jié)構(gòu),腔內(nèi)可見嗜酸性分泌物,瘤細(xì)胞中等偏大,胞質(zhì)嗜酸性,核圓形、卵圓形,核呈空泡狀,核質(zhì)比高,核分裂象多見。免疫表型:癌細(xì)胞EMA和CK、C-erb B-2均(+),CA125(灶+),ER、PR、Syn、Cg A、PTH、Inhibin、CD99、AFP、PLAP、CD30和CD20均(-),Ki-67增殖指數(shù)約60%。結(jié)論 OSCCHT臨床少見,同時伴急性腎臟功能不全更為罕見。OSCCHT是一種進(jìn)展迅速、高度惡性的卵巢惡性腫瘤,確診主要根據(jù)其臨床特點(diǎn)(血鈣升高等)、病理學(xué)特征及免疫表型,必要時可結(jié)合電鏡和分子生物學(xué)檢測輔助診斷。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of ovarian hypercalcinemic small cell carcinoma (SCC) with acute renal insufficiency. Methods the clinical data, histological morphology, immunophenotype and ultrastructure of one case of OSCCHT with acute renal insufficiency were retrospectively analyzed. Results the female patient was 29 years old. Loss of appetite and apparent wasting occurred without obvious inducement for more than one month. Laboratory examination showed abnormal renal function, and imaging showed pelvic masses, considering the source of attachments. Hemodialysis was performed after partial recovery of renal function. In the right ovary, a 12 cm 脳 10 cm tumor was seen. Under microscope, the tumor cells were distributed diffusely. The tumor cells were divided into many nodules by fibrous strips. Some of the cells could be divided into small follicles, pseudoglandular structures and eosinophilic secretions in the lumen. The tumor cells were medium large, eosinophilic in cytoplasm, round in nucleus, oval in shape, vacuolated in nucleus, high in ratio of nucleus to cytoplasm, and more frequent in mitotic appearance. Immunophenotype: the proliferative index of EMA and CK-erb B-2 in cancer cells were about 60%. The proliferative index of EMA and CKC C-erb B-2 were about 60% (P < 0.01), and the proliferative index was about 60% (P < 0.01). The proliferative index of EMA and CK-erb B-2 in cancer cells were about 60% (P < 0.01). The proliferative index of EMA and CKC C-erb B-2 were about 60%. Conclusion OSCCHT is a rapidly developing and highly malignant ovarian tumor. The diagnosis is mainly based on its clinical features (elevated serum calcium, histopathological features and immunophenotype). If necessary, it can be combined with electron microscopy and molecular biological detection to assist diagnosis.
【作者單位】： 南京軍區(qū)南京總醫(yī)院婦科;南京軍區(qū)南京總醫(yī)院病理科;
【分類號】：R737.31

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相關(guān)期刊論文 前6條

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2 喻林;楊文濤;張廷t，

本文編號：1917753