妊娠黄体瘤10例临床病理研究

Clinicopathologic study of 10 cases of pregnancy luteoma

目的：探讨卵巢妊娠黄体瘤（pregnancy luteoma,PL）的临床病理学特点、免疫表型、组织学发生、诊断及鉴别诊断。方法：对10例妊娠黄体瘤的临床特点、组织形态学和免疫组织化学及网状纤维染色的结果进行分析,并复习相关文献。结果：10例PL均为初产妇,无妊娠史;肿瘤3~10 cm,棕黄色或红褐色,质地嫩。镜下可见瘤细胞胞质嗜酸性,弥漫性增生。免疫组织化学结果示：α-inhibin,AE1/AE3,CD99及波形蛋白阳性,上皮膜抗原,S-100,HMB45及MelanA阴性。网状纤维染色结果示嗜银网状纤维呈黑色包绕在瘤细胞巢周围。结论：PL是一种罕见瘤样病变,多在妊娠末期出现,大体观、免疫组织化学染色及网状纤维染色结果有助于本病的诊断,需与类固醇细胞瘤、妊娠黄体、转移性恶性黑色素瘤等鉴别。

Objective：To determine the clinicopathologic features,histological origin,diagnosis and differential diagnosis of pregnancy luteoma in the ovary.Methods：Clinical characteristics,pathological morphology,immunohistochemical staining,and reticular fiber staining in 10 cases of pregnancy luteoma were analyzed,and literature was reviewed.Results：Ten patients were all primiparas with no pregnancy history.The sizes of pregnancy luteoma were 3-10 cm with a soft buiging appearance.Most lesions were brown but a few were black or yellow.The characteristic feature was a diffuse growth of cells with conspicuous eosinophilic cytoplasm.Immunohistochemical results showed that the expressions of α-inhibin,AEI/AE3,CD99,and Vimentin were positive,while epithelial membrane antigen（EMA）,S-100,HMB45,and MelanA were negative.Reticular fiber staining displayed that positive staining was around the cell nests of the tumor.Conclusion：Pregnancy luteoma is a rare tumor-like lesion in the late pregnancy.The gross appearance,immunohistochemical staining,and reticular fiber staining are helpful to the diagnosis of pregnancy luteoma which should be distinguished from the steroid cell tumor,corpus luteum of pregnancy,and metastatic malignant melanoma.