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目的探讨睾丸混合性生殖细胞肿瘤(MGCT)的临床病理学特征、诊断和鉴别诊断、治疗及预后。方法分析1例MGCT的临床表现和组织学形态,并复习相关文献进行讨论。结果患者左侧睾丸增大,质硬。MRI显示为多结节样肿块。镜下肿瘤由两部分不同细胞构成,A区肿瘤细胞圆形或多边形,由纤维性间隔将肿瘤组织分隔成巢团状;B区肿瘤细胞由合体滋养细胞和细胞滋养细胞组成。A区肿瘤细胞PLAP和CD117弥漫强(+),Ki-67阳性指数为50%;B区肿瘤细胞CK、α-inhibin、HCG和EMA(+),Ki-67阳性指数为90%。结论 MGCT是继精原细胞瘤之后第二个最常见的睾丸生殖细胞肿瘤,镜下肿瘤由两种或两种以上的生殖细胞组成,免疫组化对诊断及鉴别诊断有重要作用。MGCT的生物学行为和预后与其组织学类型有关。
Objective To investigate the clinical and pathological features, diagnosis, differential diagnosis, treatment and prognosis of testicular germ cell tumors (MGCT). Methods 1 case of MGCT clinical manifestations and histological morphology, and review the relevant literature for discussion. Results of the left testis increased, hard. MRI showed multiple nodular lumps. Microscopic tumor consists of two parts of different cells, A tumor cell circle or polygon, separated by fibrous tissue into a nest of fibrous tissue; B tumor cells by the syncytiotrophoblast and cytotrophoblast cells. The positive rate of Ki-67 positive index of PLAP and CD117 in A region was 50%. The positive index of CK, α-inhibin, HCG, EMA and Ki-67 in B region was 90%. Conclusion MGCT is the second most common testicular germ cell tumor after seminoma. The microscopic tumor consists of two or more germ cells. Immunohistochemistry plays an important role in diagnosis and differential diagnosis. The biological behavior and prognosis of MGCT are related to its histological type.