睾丸原发性类癌的临床病理学特点及诊治分析

Clinicopathological Features of Primary Testicular Carcinoid Tumor and Diagnosis and Treatment

目的探讨原发性睾丸类癌的临床病理学特点、免疫学表型、鉴别诊断以及诊治分析。方法采用光镜和免疫荧光染色对3例原发于睾丸类癌进行检测分析。结果 3例睾丸原发性类癌组织界限清楚,质地中等硬度,切面呈灰黄色;癌细胞较小,呈柱状或多角形,胞质中等,形态大小均一;细胞质略嗜伊红颗粒形态,胞界模糊;细胞核居中央,圆形单一,染色质点状,未见核分裂象;肿瘤细胞排列呈条索状和巢状,一些组织内可见不规则较大的腺腔样结构;各癌巢间有纤细的纤维组织间隔,未见淋巴细胞浸润;细胞层次模糊,异型性不显著,周围见血管环绕;3例癌组织经免疫荧光染色显示:神经元特异性烯醇酶(NSE)、突触素(Syn)、和嗜铬素A(Cg A)呈阳性反应,而波形蛋白(Vimentin)呈阴性表达。结论睾丸原发性类癌临床罕见,特点尚缺乏统一性,需与其他睾丸肿瘤和转移性类癌相鉴别。

Objective To investigate clinicopathological features of primary testicular carcinoid tumor and diagnosis and treatment. Methods Light microscopy and immunofluorescence staining were used to detect 3 cases of primary testicular carcinoid tumor. Results 3 cases of primary carcinoid tumors had clear dividing line,tender swelling of the testis,and luidity of section. Its cells were small,columnar or polygon,and its cytoplasm medium with uniform size,stippling chromatin and eosinophilic granular cytoplasm. The nucleus was located in center,round and single,chromatin of punctiform,without mitosis. Tumor cells were arranged as cords and nested compilation. There were some large and irregular adenoid structures. Fiber spacing was seen among tumor cells and without lymphocytic infiltration. The cellular level was obscure with indistinctive atypia and vascular circle.Immunofluorescence staining showed that NSE,Syn and Cg A were positively expressed,Vimentin was negatively expressed. Conclusion Primary testicular carcinoid tumor is extremely rare in the clinic,without the unity of its character,and it has to be differentiated from other orchioncuses and metastatic carcinoid tumor.