论文部分内容阅读
目的探讨卵巢纤维瘤合并腹膜恶性间皮瘤的诊断与鉴别诊断以及可能的发病机制。方法采用HE染色、免疫组化标记、临床追踪随访并复习文献对卵巢纤维瘤合并腹膜恶性间皮瘤进行观察分析。结果患者女性,60岁。盆腔占位伴大量腹水。组织学上卵巢为巨大纤维瘤,合并腹腔弥漫性上皮样细胞增生,细胞呈乳头状或巢片状分布,异型性不明显,核分裂少见,部分区域肿瘤向脂肪小叶内浸润生长。免疫组化:上皮样细胞MC、CR、D2-40和CK5/6(+),p16和上皮性标记物(-)。结论卵巢纤维瘤合并腹膜恶性间皮瘤罕见,发生机制不清。形态学上容易误诊为卵巢纤维瘤伴弥漫性间皮细胞增生、腹膜或卵巢原发性浆液性肿瘤,免疫标记及临床特征有助于鉴别。
Objective To investigate the diagnosis and differential diagnosis of ovarian fibroma combined with peritoneal malignant mesothelioma and its possible pathogenesis. Methods HE staining, immunohistochemical markers, clinical follow-up and review of the literature on the ovarian fibroma with peritoneal malignant mesothelioma were observed and analyzed. Results Female patient, 60 years old. Pelvic mass with a lot of ascites. Histologically ovarian giant fibroma, with diffuse intraperitoneal diffuse epithelioid cell proliferation, papillary or nested cell sheet distribution was not obvious atypia, mitotic rare, some regional tumor infiltration into the growth of fatty lobular. Immunohistochemistry: Epithelial cells MC, CR, D2-40 and CK5 / 6 (+), p16 and epithelial markers (-). Conclusions Ovarian fibroma combined with peritoneal malignant mesothelioma is rare and its mechanism is unclear. Morphologically easily misdiagnosed as ovarian fibroma with diffuse mesothelial cell proliferation, peritoneal or ovarian primary serous tumors, immune markers and clinical features help identify.