女性腹膜原发性苗勒管混合瘤临床病理和免疫组化研究

The studu of clinical pathology and immunohistochemistry for primary mixed female mullerian tumor of peritoneum

目的 观察女性腹膜原发性苗勒管混合瘤临床病理特点 ,探讨其组织发生、肿瘤类型及诊断要点。方法 用普通形态学结合免疫组化染色标记观察4例腹膜原发性苗勒管混合瘤的形态特点及肿瘤细胞对Vim、Act、CK以及ER、PR、CA125的表达情况。结果 4例中例1为良性中胚叶混合瘤(囊腺纤维瘤) ,例2为乳头状囊腺纤维瘤 ,部分交界性 ,例3为低度恶性腺肉瘤 ,例4为恶性中胚叶混合瘤 ,免疫组化显示Vim、CK在上皮和间质瘤细胞均有不同程度表达 ,同时对ER和PR也有表达 ,上皮成分尚表达CA125。结论 腹膜原发性中胚叶混合瘤起源于第二苗勒管系统 ,是一类独立的肿瘤 ,其类型包括良性腺纤维瘤 ,交界性以及恶性中胚叶混合瘤 ,组织学特征与生殖系统分化程度相同的同类型肿瘤相一致 ,诊断时应排除生殖系统无同类型肿瘤存在。恶性中胚叶混合瘤中癌瘤成分是影响愈后的主要因素。

Objective To study histogenesis and morphologic features of 4 primary mixed mullerian tumor of female peritoneum and its patholigcal classfication. Methods H&E staining, immunohistochemical stainings were used. Results Among 4 primary mixed tumor there were 1 case of cystic adenofibroma(case 1),second was cystic papillary adenofibroma,part of borderline(case 2),anoter was adenosarcoma(case 3),last case of malignant mixed mullerian tumor(case 4). Immunohistochemically,coexpression of keratin and vimentin was observed focally in both epithelial and mesenchymal components in all cases, whereas coexpression of ER and PR in all,epithelial components were postive with carcinoma antigens 125 in three cases. Conclustions Primary mixed tumor of female peritoneum are considered arising from the secondary mullerian system. These tumors were histologically identical to that of the similar mixed tumor arising from the genital. The diagnosis was made only when the ovaries are not involved and without no any evidence of tumor obtained in the ovaries or uterus of uriary organs. Carcinomotous components in the primary malignent mixed mullerian tumor of the female peritoneum play an important role in the prognosis this tumor.