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目的:探讨双侧卵巢及宫颈粒细胞肉瘤的临床病理学特征、诊断及鉴别诊断。方法:在光学显微镜下观察1例双侧卵巢及宫颈粒细胞肉瘤的病理标本,对其行免疫组化检测,并结合文献进行分析。结果:1例双侧卵巢及宫颈粒细胞肉瘤患者(46岁),B超发现双侧盆腔包块,半年前诊断为急性非淋巴细胞白血病-粒细胞白血病部分分化型(ANLL-M2)。光镜下,可见双侧卵巢及宫颈肿块内中等大小相对一致的肿瘤细胞呈弥漫浸润性生长,肿瘤细胞细胞质少,细胞核呈圆形或卵圆形,核膜厚,核分裂象易见,肿瘤细胞间可见少量未成熟嗜酸粒细胞。免疫组化示,肿瘤细胞表达MPO、CD43、CD117、Ki-67(30%+)。结论:双侧卵巢及宫颈粒细胞肉瘤十分罕见,形态学易与其他小细胞肿瘤混淆,免疫组化有助于诊断与鉴别诊断。粒细胞肉瘤恶性程度高,患者预后差。
Objective: To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of bilateral ovarian and cervical granulocystic sarcoma. Methods: One case of ovarian and cervical granulocystic sarcoma was observed under optical microscope. Immunohistochemistry and immunohistochemistry were used to analyze the pathological specimens. Results: One case of bilateral ovarian and cervical granulocytic sarcoma (46 years old) had a bilateral pelvic mass in the B-mode ultrasound and a partial diagnosis of acute non-lymphocytic leukemia-myeloid leukemia (ANLL-M2) six months ago. Light microscope, we can see bilateral ovarian and cervical mass relatively uniform size of the tumor cells were diffuse infiltration of growth, tumor cells less cytoplasm, the nucleus was round or oval, nuclear membrane thickness, mitotic easy to see, tumor cells Between a small amount of immature eosinophils can be seen. Immunohistochemistry showed that the tumor cells expressed MPO, CD43, CD117 and Ki-67 (30% +). Conclusion: Bilateral ovarian and cervical granulocytic sarcomas are rare, and their morphology is easily confused with other small cell tumors. Immunohistochemistry may be helpful for diagnosis and differential diagnosis. Granulocytic sarcoma has a high degree of malignancy and has a poor prognosis.