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目的:探讨子宫上皮样滋养细胞肿瘤的临床病理学特征。方法:复习3例子宫上皮样滋养细胞肿瘤的临床资料,并进行组织病理学和免疫组织化学方法观察。结果:3例子宫上皮样滋养细胞肿瘤患者的年龄分别36、46和48岁。临床上主要表现为不规则的阴道流血和盆腔包块。组织学检查显示肿瘤主要由相对单一的单个核滋养细胞组成,排列成片状和条索状的紧密细胞巢,常见广泛坏死区周围绕以存活的瘤细胞岛,形成“地图样外观”。免疫组化标记检查显示瘤细胞表达人体胎盘催乳素(hPL)、β-人绒毛膜促性腺激素(β-hCG)、胎盘碱性磷酸酶(PLAP)、细胞角蛋白(CKpan)、CK18、上皮膜抗原(EMA)、表皮因子生长受体(EGFR)、上皮钙黏素、黑色素瘤细胞黏附分子(Mel-CAM)和抑制素-α。结论:子宫上皮样滋养细胞肿瘤是罕见的、起源于中间滋养细胞的肿瘤。确诊依赖于组织病理学观察和免疫组织化学标记。
Objective: To investigate the clinicopathological features of uterine epithelioid trophoblastic tumor. Methods: The clinical data of 3 cases of uterine epithelium-like trophoblastic tumor were reviewed and observed by histopathology and immunohistochemistry. Results: The age of patients with uterine epithelium-like trophoblastic tumor were 36, 46 and 48 years old respectively. The main clinical manifestations of irregular vaginal bleeding and pelvic mass. Histological examination revealed that the tumor mainly consisted of a relatively single single nucleocapsid trophoblast arranged in the form of lamellar and cord-like tight cell nests. Survival of tumor cells around the common necrotic area was common, resulting in a “map-like appearance.” Immunohistochemical staining showed that the tumor cells expressed human placental prolactin (hPL), β-human chorionic gonadotropin (β-hCG), placental alkaline phosphatase (PLAP), cytokeratin (CKpan) Membrane antigen (EMA), epidermal growth factor receptor (EGFR), e-cadherin, melanoma cell adhesion molecule (Mel-CAM) and inhibin-alpha. Conclusions: Uterine epithelioid-like trophoblastic tumors are rare tumors that originate in the middle trophoblast. Confirmed diagnosis depends on histopathology and immunohistochemical markers.