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目的探讨睾丸绒毛膜癌(绒癌)的临床及病理学特征。方法对2例睾丸绒癌进行临床资料分析、组织形态学观察及免疫组化检测,并复习相关文献。结果 2例患者年龄分别41岁和21岁,均以睾丸肿物为首发症状,确诊时均已出现肺部多发转移。例1,镜下见肿瘤组织有较广泛的出血、坏死,出血区边缘见肿瘤组织由细胞滋养叶细胞及合体滋养叶细胞组成。例2,部分区域为精原细胞瘤,部分区域瘤组织呈巢状、条索状排列,可见大而异型、胞质丰富、粉染或空泡状的多核巨细胞并伴有明显出血、坏死。免疫表型:2例绒癌细胞CK和HCG均(+),而CD117、CD30、AFP、inhibin及OCT4(-)。结论睾丸绒癌是罕见的高度恶性肿瘤,易发生肺、脑转移。依据临床和病理组织学特点并结合免疫组化染色可明确诊断。
Objective To investigate the clinical and pathological features of testicular choriocarcinoma (choriocarcinoma). Methods The clinical data of 2 cases of testicular choriocarcinoma were analyzed, histomorphological observation and immunohistochemistry were performed, and the related literatures were reviewed. Results The two patients were 41 years old and 21 years old respectively, with testicular tumor as the first symptom. Multiple pulmonary metastases had been diagnosed at the time of diagnosis. Example 1, microscopic tumor tissue see a more extensive bleeding, necrosis, bleeding edge of the tumor tissue seen by the trophoblast cells and syncytiotrophoblast leaf cells. Example 2, part of the area of seminoma, part of the tumor was nested, cord-like arrangement, showing large and abnormal, cytoplasm rich, pollination or vacuolar multinucleated giant cells accompanied by significant bleeding, necrosis . Immunophenotype: Two cases of choriocarcinoma CK and HCG were (+), while CD117, CD30, AFP, inhibin and OCT4 (-). Conclusion Testicular choriocarcinoma is a rare and highly malignant tumor, prone to lung and brain metastases. According to clinical and histopathological features combined with immunohistochemical staining can confirm the diagnosis.