论文部分内容阅读
目的:对子宫内膜大细胞神经内分泌癌的临床病理特征、诊断及鉴别诊断作一总结。方法:回顾性分析2例子宫内膜大细胞神经内分泌癌患者的临床表现,肿瘤组织学形态、免疫组化特征,并进行相应的文献复习。结果:2例患者年龄分别为87岁、44岁,均因阴道异常流血而行诊断性刮宫确诊,并行根治性手术。肉眼观2例肿物均呈息肉状。显微镜下病例1见癌组织大部分区域呈巢团状、条索状分布,局灶区域呈微腺管样结构并呈菊形团样;病例2癌组织主要呈巢团状分布,癌细胞体积偏大,胞浆少、核染色质呈烟灰样。免疫组化病例1肿瘤细胞示Cg A、CK7、AE1/AE3、EMA、P16、P53、ER和PR均阳性,CD56和Syn局灶阳性,WT1、CD10和NSE均阴性;病例2示CK7、Syn和NSE均阳性,CD56、P53局灶阳性,ER、AE1/AE3、EMA、CD10、WT1均阴性。结论:子宫内膜大细胞神经内分泌癌是一种罕见肿瘤,它也可与其他类型癌同时发生,具有高侵袭性,预后较差。
Objective: To summarize the clinical and pathological features, diagnosis and differential diagnosis of endometrial large cell neuroendocrine carcinoma. Methods: Two cases of endometrial large cell neuroendocrine carcinoma were retrospectively analyzed. The clinical manifestations, histological features and immunohistochemical features of the tumors were analyzed retrospectively. Results: The age of two patients were 87 years old and 44 years old. All of them were diagnosed by diagnostic curettage due to abnormal vaginal bleeding. The patients underwent radical surgery. Macroscopic two cases showed polypoid tumor. Microscopically, most of the cancerous tissues showed nest-like and cord-like distribution in most cases, and microtubule-like structures in the focal area showed a daisy-like pattern. In case 2, the majority of cancerous tissues were nest-like and the size of cancer cells Large, less cytoplasm, nuclear chromatin was ashes. ImmunohistochemistrySample 1 The tumor cells showed positive of Cg A, CK7, AE1 / AE3, EMA, P16, P53, ER and PR, positive of CD56 and Syn, negative of WT1, CD10 and NSE; And NSE were positive, CD56, P53 focal positive, ER, AE1 / AE3, EMA, CD10, WT1 were negative. CONCLUSIONS: Endometrial large cell neuroendocrine carcinoma is a rare tumor that can also occur concurrently with other types of cancer with high aggressiveness and poor prognosis.