通过腹膜积液分析细胞学诊断与妊娠相关的生殖细胞异常瘤:1例报告。

IF 2.3 3区 医学 Q2 PATHOLOGY
Liyan Huang, Lian Xu
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引用次数: 0

摘要

背景:异常生殖细胞瘤是一种起源于原始卵巢生殖细胞的罕见恶性肿瘤,在妊娠期间极为罕见。虽然有几项研究通过腹膜积液细胞学证实了异常生殖细胞瘤的诊断,但迄今为止还没有怀孕期间确诊的病例报告。本研究报告了第一例妊娠患者通过腹膜积液细胞学诊断为生殖细胞异常瘤。病例介绍:一名27岁的孕妇在当地医院b超检查发现早期宫内妊娠,右侧附件肿块。腹膜积液的细胞学检查显示多态细胞群,以分散的大肿瘤细胞为主,混合有反应性淋巴细胞和组织细胞。这些肿瘤细胞表现出中度至丰富的嗜酸性或空泡状细胞质,边界明确。大多数细胞核圆或卵圆形,核质比高,染色质颗粒状,分布不均匀,部分细胞可见明显的核仁。而大细胞的子集显示不规则的核轮廓和角状外观。细胞阻滞(CB)免疫细胞化学(ICC)结果显示SALL4、CD117、OCT3/4、PLAP、D2-40阳性,LCA、CD30、EMA、CK-P、CR、SF-1阴性。结合腹膜积液细胞学、细胞阻滞分析和ICC结果,最终诊断为异常生殖细胞瘤。患者接受了右附件切除术,随后在妊娠36 + 4周时产下一名健康的女婴。术后4年随访未见疾病复发。结论:本报告描述了腹膜积液中异常生殖细胞瘤的细胞病理学特征,特别是存在离散的大肿瘤细胞,核深染,核仁突出。细胞病理学家应对该实体保持高度的怀疑,特别是在年轻患者中,并采用包括细胞形态学评估,CB检查和免疫细胞化学分析在内的综合诊断方法来做出准确的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cytological diagnosis of dysgerminoma associated with pregnancy via peritoneal effusion analysis: a case report.

Background: Dysgerminoma, a uncommon malignant neoplasm originating from primitive ovarian germ cells, is exceptionally rare during pregnancy. While several studies have documented dysgerminoma diagnosis via peritoneal effusion cytology, no cases identified during pregnancy have been reported to date. This study presents the first reported case of dysgerminoma diagnosed through peritoneal effusion cytology in a pregnant patient.

Case presentation: A 27-year-old pregnant woman presented to our hospital with an early intrauterine pregnancy and a right adnexal mass detected on B-ultrasound at a local hospital. Cytological evaluation of the peritoneal effusion revealed a polymorphic cell population dominated by discrete large tumor cells mixed with reactive lymphocytes and histiocytes. These tumor cells exhibited moderate to abundant eosinophilic or vacuolated cytoplasm with well-defined borders. Most had round or oval nuclei with high nuclear-to-cytoplasmic (N/C) ratios, granular chromatin with uneven distribution, and distinct nucleoli visible in some cells. While a subset of large cells showed irregular nuclear contours and angular appearances. Immunocytochemistry (ICC) results of cell block (CB) showed positive staining for SALL4, CD117, OCT3/4, PLAP, and D2-40, but negative staining for LCA, CD30, EMA, CK-P, CR, and SF-1. The final diagnosis of dysgerminoma was made by integrating peritoneal effusion cytology, cell block analysis, and ICC results. The patient underwent right adnexectomy and subsequently delivered a healthy female infant at 36 + 4 weeks of gestation. Four-year postoperative follow-up showed no evidence of disease recurrence.

Conclusion: This report describes the cytopathological features of dysgerminoma in peritoneal effusion, specifically the presence of discrete large tumor cells with hyperchromatic nuclei and prominent nucleoli. Cytopathologists should maintain a high index of suspicion for this entity, particularly in young patients, and adopt a comprehensive diagnostic approach including cytomorphological assessment, CB examination, and immunocytochemical analysis to make an accurate diagnosis.

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来源期刊
Diagnostic Pathology
Diagnostic Pathology 医学-病理学
CiteScore
4.60
自引率
0.00%
发文量
93
审稿时长
1 months
期刊介绍: Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).
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