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[讨论整理] 浆粘液性肿瘤,够不够癌?【中美加卵巢肿瘤病理交流群307】

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发表于 2018-11-9 14:06:41 | 显示全部楼层 |阅读模式
病例信息
性别:年龄:38
临床诊断:
一般病史:
标本名称:右卵巢肿物
大体所见:
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本帖最后由 病理老周 于 2018-11-9 14:09 编辑

张萍
请教老师一个病例,女,38岁,B超检查发现右侧卵巢囊肿三天,腹腔镜下行肿瘤切除,病理肉眼:已破的囊壁样组织碎块,总体积8*5*1立方厘米,囊壁厚0.2–0.3厘米,可见散在大小不一的乳头,质软。倾向卵巢高级别浆液性癌,免组不太支持,
盆腔冲洗液如图29-31,细胞蜡块中见肿瘤细胞免疫组化结果:WT-1(-),PR(-),P53弱阳性,野生型,CA125部分阳性,P16阳性,ER阳性,Ki67约20%。

杨鹏
@张萍银川市妇幼保健院 卵巢有没有子宫内膜异位症?

张萍
@杨鹏  淄博市妇幼保健院 没有子宫内膜异位症

邢德印
@张萍银川市妇幼保健院 张主任,这个不是HGSC. 杨主任看本质,这个是浆粘
如果是浆粘,那么至少是交界性浆粘. 问题是够不够浆粘癌. 目前看个人觉得不太够. 另外,有很多人认为浆粘癌是不存在的
第二个问题是需要广泛取材以排除透明细胞癌. 有clue,但还不够. ccc 和浆粘致癌机制一样. 有时共存
39.jpg

吴传真
@张萍银川市妇幼保健院 癌是肯定的

赵澄泉
网上看图不清,同意德印,有些似浆粘,但需考虑够癌了
40.jpg

赵澄泉
我们昨天journal club fellow presented a paper about seromucinous tumor. You can take them if u are interested
Seromucinous ovarian tumor A comparison with the rest of ovarian epithelial tumors.pdf (2.18 MB, 下载次数: 9)
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发表于 2018-11-12 23:03:27 来自手机 | 显示全部楼层
不止交界了,应该是癌了。
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发表于 2019-1-4 17:32:41 | 显示全部楼层
Seromucinous ovarian tumor A comparison with the rest of ovarian
epithelial tumors☆
Georgia Karpathiou a,⁎, Celine Chauleur b, Thomas Corsini b, Melany Venet a, Cyril Habougit a,
Freschia Honeyman a, Fabien Forest a, Michel Peoc'h a
a Department of Pathology, North Hospital, University Hospital of St-Etienne, France
b Department of Gynecology and Obstretics, North Hospital, University Hospital of St-Etienne, France
a r t i c l e i n f o a b s t r a c t
Background: Seromucinous ovarian tumors are rare and not adequately described in the literature and this is especially
true for seromucinous carcinomas.
Aimof the study: To describe histological and clinical features of these tumors in comparisonwith the rest of ovarian
epithelial tumors.
Materials and methods: Two hundred and forty one (241) ovarian tumors, borderline (n=92) or malignant (n=
149), treated surgically without neoadjuvant chemotherapy, were examined.
Results: Seromucinous borderline (SMBT) and malignant tumors (SMC) comprised 7.8% (n=7) and 4% (n=6)
of all borderline tumors and carcinomas, respectively, studied.Mean age of diagnosis was 63.2 and 68.3 years and
mean size was 6.4 cm and 12 cm for SMBT and SMC, respectively. Seromucinous tumors were associated with
endometriosis in 23.1% of the cases and they were bilateral in 30.8%. Microscopically, variety in cellular composition,
papillary architecture and development into thickwalled, occasionallymuscular, cystswere themain findings.
Medullary/paraovarian/tubal or deeply cortical localization was also characteristic. Stage predicted overall
and progression-free survival (p b 0.0001 and p = 0.03, respectively). Five-year survival was 62% for patients
with high grade serous carcinoma, 55% for seromucinous carcinoma, 100% for endometrioid carcinoma, 75%
for clear cell carcinoma, and 80% for patientswithmucinous carcinoma. Differenceswere not however statistically
significant.
Conclusion: Seromucinous tumors have unique features that support their classification as a different entity. Their
localization
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发表于 2019-1-4 17:48:09 | 显示全部楼层
读了赵老师的提供的这篇文献,好象要诊断为浆粘液性癌
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