20例睾丸和附睾腺瘤样瘤的临床病理、特染及免疫组化观察

Clinical pathological analysis of 20 cases adenomatoid tumors in testis and epididymides with special dyeing and immunohistochemical methods

目的 :用特殊染色、免疫组化的方法探讨男性生殖系统腺瘤样瘤的组织发生、特性及鉴别诊断。方法 :收集睾丸和附睾腺瘤样瘤病例 2 0例 ,选用细胞角蛋白 (CK) ,波纹蛋白 (VIM) ,上皮膜抗原 (EMA) ,癌胚抗原 (CEA) ,S— 10 0蛋白 ,血管VⅢ因子相关抗原 (FVⅢ ) ,平滑肌肌红蛋白 (SMA) ,溶菌酶 (LYS) ,神经原纤维 (NF)作为第一抗体 ,应用免疫组化方法 (SP法 )以及特殊染色 :AB—PAS染色 ,网状纤维染色 ,Masson三色染色 ,观察其临床病理特征。结果 :免疫组化结果显示 2 0例睾丸和附睾腺瘤样瘤的CK及VIM均呈强阳性 ,EMA8例阳性 ( 4 0 % ) ,S— 10 0蛋白 2例阳性 ( 10 % ) ,SMA10例阳性 ,CEA ,EMA ,FVⅢ ,MYO及NF均无表达。AB—PAS染色 2 0例均有阳性反应 ,网状纤维染色见瘤细胞周围网状纤维少 ,Masson三色染色部分间质呈红色。结论 :男性生殖系统腺瘤样瘤为间皮起源 ,附睾及其附近为最常见部位 ,CK ,VIM及AB—PAS染色是睾丸及附睾腺瘤样瘤的阳性标记物 ,特染及免疫组化结果可作为诊断及鉴别诊断的重要参考依据。其生物学行为为良性 ,预后良好。

Objective: To study the adenomatoid tumors in testis and epididymides with special dyeing and immmunohistochemical methods.Methods: 20 cases of the adenomatoid tumors in testis and epididymides were detected and investigated. The panel of cytokeratin (CK), vimentin (VIM),epithelial membrane antigen (EMA),carcinoembryonic antigen (CEA), S-100protin(S-100), VIII factor, smooth muscle myoglobin (SMA), lysozyme(LYS) and neurofibril(NF) were tested on these cases by the way of immunohistochemical methods (SP methods). Alcian Blue and Schiff(AB-PAS)stainning, Reticular fiber stainning and Masson stainning were also done. Results: Strong positivity for CK and VIM were noted in the tumor cells of the 20 cases, but negative for CEA, VIII factor, LYS, NF,EMA, S-100 and SMA were positive in 8, 2 and 10 cases respectively. All 20 cases showed AB-PAS stainning positive. Few of reticular fibers around the tumor cells were found by reticular fiber stainning. 10 cases showed Masson stainning red. Conclusions: Adenomatoid tumor of the testis and epididymides is mesothelial in origin and epididymides is considerded as the most common site of occurance. The very important positive markers are helpful for diagnosis and differential diagosis including the markers of CK, VIM and AB-PAS stainning. The biological behavior of adenomatoid tumor is benign and with a good prognosis.