生殖系统外原发性上皮样滋养细胞肿瘤临床特点及病理改变(1例报告并文献复习)

Clinical features and pathological changes of primary epithelioid trophoblastic tumor of extra-genital system

目的探讨生殖系统外原发性上皮样滋养细胞肿瘤的临床病理特点。方法分析1例以脑肿瘤为首发症状的上皮样滋养细胞肿瘤的临床和病理资料,结合文献进行讨论,辅助头颅CT、核素扫描、胸片、腹部B超检查,观察病变的大体及镜下特点,采用HE染色及免疫组化S-P法标记CK、HPL、HCG。结果以脑肿瘤为首发症状的上皮样滋养细胞肿瘤临床主要表现为头痛、头晕、视力下降及颅内多发占位性病变。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。免疫组化标记瘤细胞CKP(+++),CEA(++),EMA(++),PLAP(++),Vimentin(+),S-100(-),HCG(+)。结论以脑肿瘤为首发症状的生殖系统外原发性上皮样滋养细胞肿瘤的诊断及鉴别诊断主要依赖于病理形态学及免疫组织化学检查。

Objective To investigate the clinicopathological features of primary epithelioid trophoblastic tumor of extra-genital system. Methods By means of histological, immunohistochemieal and histoehemical studies, the clinical and pathological features of primary epithelioid trophoblastic tumor of extra-genital system was analyzed in one patient. CK, HPL and HCG were marked by HE and S-P staining. Results The patient presented headache, dizziness and a decrease in vision. MRI showed intracerebral masse lesions. The tumor was composed of epithelioid trophobiastic tumor cells. Immunohistoehemical expressions of CKP, CEA, EMA, PLAP, Vimentin and HCG were positive and that of S100 protein was negative in the tumor cells. Conclusion Primary epithelioid trophoblastic tumor of extra-genital system is a rare tumor which shows epithelioid differentiation. Its diagnosis is based on histological and immunohistoehemieal staining.