本文選題：睪丸腫瘤　切入點：睪丸腎上腺殘余腫瘤　出處：《中山大學(xué)學(xué)報(醫(yī)學(xué)科學(xué)版)》2015年06期 　論文類型：期刊論文

【摘要】：【目的】睪丸腎上腺殘余腫瘤(TART)是睪丸少見良性腫瘤,因其罕見常易誤診為睪丸間質(zhì)細胞瘤等其他腫瘤,是臨床診斷難點。本研究收集并總結(jié)了13例TART的病理臨床特點,目的是提高對該病的認識和臨床診斷水平�！痉椒ā渴占猩酱髮W(xué)附屬第一醫(yī)院2009-2014年間13例確診的TART病例,通過回顧影像學(xué)資料和病理組織學(xué)特點、免疫組化染色、結(jié)合臨床癥狀預(yù)后分析,歸納TART的臨床病理特點�！窘Y(jié)果】13例TART患者均為男性,平均年齡12.15歲,臨床均表現(xiàn)為腎上腺皮質(zhì)綜合癥(CAH),雙側(cè)睪丸同時發(fā)病。B超檢查顯示雙側(cè)睪丸均為孤立性病灶,病變位于睪丸網(wǎng)或圍繞睪丸縱隔生長。病變形態(tài)多樣,邊界清楚,無包膜,以低回聲為主,部分病灶內(nèi)血供豐富。腫瘤大小0.2~4 cm,平均1.1 cm。組織學(xué)檢查顯示睪丸腫瘤形態(tài)類似于腎上腺皮質(zhì),瘤細胞胞質(zhì)豐富紅染,核居中,可見小核仁,但核分裂像少見,未見病理性核分裂像。腫瘤與周圍組織分界清,未見鄰近組織和血管侵犯。免疫組化染色顯示腫瘤細胞彌漫表達波形蛋白和抑制素a,但均不表達神經(jīng)內(nèi)分泌標記,Ki-67指數(shù)小于1%。13例患者均行手術(shù)完整剔除腫瘤,術(shù)后隨訪3月~6年,無腫瘤復(fù)發(fā)�！窘Y(jié)論】TART常與CAH伴發(fā),腫瘤具有腎上腺皮質(zhì)特征。對CAH患者行睪丸超聲檢查有助于早期發(fā)現(xiàn)腫瘤,及時挽救睪丸功能。TART手術(shù)切除預(yù)后良好,無需術(shù)后輔助治療。
[Abstract]:[objective] the residual tumor of testicular adrenal gland (TARTT) is a rare benign tumor of testis, which is often misdiagnosed as testicular stromal cell tumor and other tumors, which is difficult in clinical diagnosis. This study collected and summarized the pathological and clinical features of 13 cases of TART. Objective to improve the recognition and clinical diagnosis of the disease. [methods] 13 cases of TART diagnosed in the first affiliated Hospital of Sun Yat-sen University from 2009 to 2014 were collected. The clinicopathological features of TART were summarized. [results] all 13 patients with TART were male, with an average age of 12.15 years. The clinical manifestations were adrenocortical syndrome (CAH), the bilateral testis were at the same time. B-ultrasonography showed that the bilateral testis were solitary lesions, and the lesions were located in the testicular reticulum or around the testis mediastinum. The lesions were varied in shape, with clear boundary and no capsule. The tumor size was 0.2 ~ 4 cm, with an average of 1.1 cm. Histological examination showed that the shape of testicular tumor was similar to that of adrenal cortex, the cytoplasm of tumor cells was rich in red stain, the nucleus was in the middle, small nucleoli could be seen, but the mitosis was rare. No pathological mitosis was seen. The boundary between the tumor and the surrounding tissue was clear. There was no invasion of adjacent tissues and blood vessels. Immunohistochemical staining showed diffuse expression of vimentin and inhibin a in tumor cells, but no neuroendocrine marker Ki-67 was found in all of the 13 patients. Follow up from March to 6 years after operation, no tumor recurred. [conclusion] TART is often associated with CAH, and the tumor has adrenal cortical features. Testicular ultrasound examination in CAH patients is helpful for early detection of tumor, and timely rescue of testicular function. TART surgery has a good prognosis. There is no need for postoperative adjuvant treatment.
【作者單位】： 中山大學(xué)附屬第一醫(yī)院病理科;中山大學(xué)附屬第一醫(yī)院超聲科;中山大學(xué)附屬第一醫(yī)院轉(zhuǎn)化醫(yī)學(xué)中心;
【分類號】：R737.21

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