输卵管系膜交界性上皮性肿瘤4例临床病理分析

Borderline mesosalpinx epithelial tumors: a clinicopathological analysis of 4 cases

目的探讨输卵管系膜交界性上皮性肿瘤的临床病理学特点及组织起源。方法回顾性分析4例输卵管系膜交界性上皮性肿瘤的临床资料、大体形态、组织学形态及免疫组化结果。结果仅1例主诉下腹痛,其余3例为术前B超或术中发现附件肿块,病变无盆腹腔种植转移;肿瘤位于输卵管系膜内,与同侧卵巢、输卵管分离,囊性,见囊内乳头状赘生物或囊内壁粗糙;乳头为2级或3级,上皮明显增生,可呈筛状,见脱落的上皮细胞簇,细胞轻到中度异型,核浓染,大小较一致,核分裂罕见,未见破坏性间质浸润。免疫组化:CK7和pax8(+),CK20和calretinin(-),CK5/6局灶(+)。术后随访,均无复发。结论输卵管系膜交界性上皮性肿瘤从苗勒管囊肿发展而来,多为单侧发生,无腹膜种植,术式参照卵巢同类肿瘤,预后好。

Objective To explore the clinicopathological characteristics and the histologic origin of borderline mesosalpinx epithelial tumors.Methods Clinical data,gross morphology,histological appearance and immunohistochemical results were analyzed in four borderline mesosalpinx epithelial tumors.Results Only one patient complained of lower abdominal pain,the other threetumors were discovered by preoperative B-sonography or surgery.All of them had no pelvic metastasis lesions;the tumors was cystic with a variable number of excrescences or with rough wall,separated from ipsilateral ovary and oviduct.The papillas developed to a second or third degree.The lined epithelium of the cyst and papilla was obviously hyperplastic,sometimes showed a cribriform architechure.The detached epithelial cell clusters always appeared in the cavity;cells were mild to moderate atypia,hyperchromatic nuclei with uniform size were seen,mitotic figures were rare.Moreover,the tumor had no destructive stromal invasion.CK7 and pax8 were positive in the tumors cells,calretinin and CK20 were negative,and CK5/6 expressed locally.Postoperative follow-up of all these cases showed that there was no recurrence.Conclusion Borderline mesosalpinx epithelial tumors may arise from the Mullerian duct cyst.Their pathological diagnoses are similar to their counterparts arising from ovary.They occur mostly in unilateral mesosalpinx,have no peritoneal planting.At present the operation refers to the similar tumors of ovarian and the prognosis is good.It is necessary to collect more cases to know whether and how the bordline tumors can be developed to cancers in order to diagnose and treat them correctly.