卵黄囊瘤11例临床病理分析

Clinicopathological analysis of yolk sac tumor:A series of 11 cases

目的：探讨卵黄囊瘤（ YST）的临床病理特征,以提高对该肿瘤的认识。方法回顾性收集11例YST,观察分析其临床病理和免疫表型特点,并结合文献探讨该病特点。结果在11例中男性5例,女性6例；平均年龄19岁（8个月至52岁）；4例位于卵巢,3例位于睾丸,3例位于纵膈,1例位于腹膜后。肿块的平均直径为9.2cm（2.0～14.0cm）。6例为单纯性YST,5例为混合性恶性生殖细胞肿瘤。肿瘤多有包膜,结节状,切面呈囊实性,常有出血、坏死区；组织形态多样,可呈疏松黏液样、微囊网状、巨囊、实性、乳头状、腺样、肝样等,可见Schiller-Duval小体、基底膜样物质、透明小体。瘤细胞表达AFP （11/11）、CD117（5/11）、PLAP（6/11）,CD30均阴性。结论 YST多发生于婴幼儿和青少年的性腺内,常伴有血清AFP升高,组织学形态多样。

Objective To investigate the clinicopathological features of yolk sac tumor （ YST） , so as to improve the understanding of the disease. Methods Eleven cases of YST were retrospectively studied to observe their pathological features and immunophenotype combining literature. Results The age of 11 patients （5 males and 6 females） ranged from 8 months to 52 years （average age of 19 years）. YST was located at ovary in 4 cases, at testis in 3 cases, at mediastinum in 3 cases, and at retroperitoneal in 1 case. The mean tumor diameter was 9. 2cm （2. 0-14. 0cm）. Five cases were mixed germ cell tumor, and 6 cases were simple YST. Most tumors appeared as nodules with complete capsule. The cut surface was solid and cystic with hemorrhage and necrosis regions. YST had various histologic characteristics, such as loose mucus, microcyst reticular, macrocyst, solidity, papillary shape, glandular shape, hepatoid shape, and Schiller-Duvalbody, basement membrane, and hyaline body. Immunohistochemically, the tumor cells were positive for AFP （ 11/11 ） , CD117 （ 5/11 ） and PLAP （6/11） but negative for CD30. Conclusion Most YST occur in the gonads of children and adolescence, often complicated with elevated serum AFP and various histologic characteristics.