卵巢恶性混合性生殖细胞瘤临床病理分析

Clinical pathology analysis of ovarian malignant mixed germ cell tumor

目的:观察右侧卵巢混合性生殖细胞肿瘤病理形态,进一步探讨其组织起源,病理学诊断及鉴别诊断。方法:对一例卵巢混合性生殖细胞肿瘤的临床病理学资料进行回顾性分析总结。结果:①患者女,20岁;②卵巢混合性生殖细胞肿瘤病理形态主要表现为卵黄囊瘤和精原细胞瘤结构。卵黄囊瘤结构复杂,细胞异型性明显,基本结构为网状结构、实性结构、内胚窦样结构、透明小体。无性细胞瘤瘤细胞大小较一致,有纤细纤维组织分隔及淋巴样细胞浸润。③卵巢混合性生殖细胞肿瘤常规组织学与未分化癌、颗粒细胞瘤、透明细胞癌、未成熟畸胎瘤有时易混淆,患者年龄、组织学形态及免疫组化检查等有助于明确诊断。结论:①卵巢恶性混合性生殖细胞肿瘤起源于生殖细胞。②卵巢恶性混合性生殖细胞肿瘤可发生误诊,免疫组化检查、年龄、组织学形态等有助于鉴别诊断。③卵巢恶性混合性生殖细胞肿瘤具有高度浸润性,易复发。治疗上采取手术治疗加术后辅助治疗。

Objective： To observe the right ovary mixed germ cell tumors pathological form, further discussing its organization origin, pathology diagnosis and differential diagnosis. Methods： the case of ovarian mixed germ cell tumors of clinical pathology were analyzed retrospectively summarized. Results： （1）patients.with female, 20 years old, （2）ovarian mixed germ cell tumors pathological morphology mainly for yolk-sac tumors and seminoma structure. Yolk-sac tumors structure is complex, cellular pleomorphism, basic structure for mesh structure, solid structure, within the embryo sinus sample structure, transparent vorkommen. Asexual cell tumor tumor cell size is consistent, a slim fibrous tissue space and lymphoid cells infiltration. （~ovarian mixed germ cell tumors routine histology and anaplastic carcinoma, granulosa cell tumor, transparent cell carcinoma, immature teratomas sometimes confusingly, patients age, histological appearance and immunohistochemical inspection helps clear diagnosis. Conclusions： （1）ovarian malignant mixed germ cell tumors originated in reproductive cells. （2）ovarian malignant mixed germ cell tumors can happen misdiagnosis, immunohistochemical check, age, histological appearance etc helps the differential diagnosis. （3）ovarian malignant mixed germ cell tumors highly invasive, easy recrudesce. Treatment takes surgical treatment with postoperative adjuvant therapy.