本文選題：腎上腺腫瘤 + 腎上腺皮質(zhì)癌　； 參考：《臨床與實驗病理學(xué)雜志》2017年11期

【摘要】：目的探討腎上腺皮質(zhì)癌(adrenocortical carcinoma,ACC)的臨床病理特征及其網(wǎng)狀纖維染色意義。方法收集20例腎上腺皮質(zhì)腺瘤(adrenocortical adenoma,ACA)和16例ACC,分析兩者的臨床、影像學(xué)、病理特點、網(wǎng)狀纖維染色,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 ACA中位病程21個月,腫瘤最大中位直徑2.6 cm;ACC中位病程5個月,腫瘤最大中位直徑9.5 cm,9例診斷時已發(fā)生遠(yuǎn)處轉(zhuǎn)移。ACA瘤細(xì)胞呈巢團(tuán)狀、粗梁狀排列,胞質(zhì)嗜酸或透明,核異型不明顯,核分裂象罕見,無包膜、竇隙、靜脈侵犯,出血、壞死、粗大膠原纖維少見。Weiss積分均≤2分,平均(0.85±0.81)分。ACC癌細(xì)胞呈巢團(tuán)狀、粗梁狀、條索狀或彌漫性排列,多數(shù)胞質(zhì)嗜酸性,可見不同程度的核異型以及非典型核分裂,可見包膜、竇隙、靜脈侵犯,出血、壞死、粗大膠原纖維易見。Weiss積分均≥3分,平均(5.2±1.3)分。免疫表型:ACA、ACC中vimentin、Syn、NSE、CK、CR、Melan-A、α-inhibin的表達(dá)比較差異無統(tǒng)計學(xué)意義(P0.05)。網(wǎng)狀纖維染色:20例ACA網(wǎng)狀纖維結(jié)構(gòu)規(guī)則完整,未見斷裂、塌陷、稀疏或消失;16例ACC網(wǎng)狀纖維結(jié)構(gòu)破壞,不同程度的斷裂、塌陷、稀疏或消失,兩者網(wǎng)狀纖維結(jié)構(gòu)破壞率比較差異有統(tǒng)計學(xué)意義(P0.01)。結(jié)論ACC的免疫表型缺乏特征性,直徑增大、遠(yuǎn)處轉(zhuǎn)移、粗大膠原纖維、網(wǎng)狀纖維結(jié)構(gòu)破壞對判斷惡性特征具有重要意義。
[Abstract]:Objective to investigate the clinicopathological features and the significance of reticular fiber staining in adrenocortical carcinoma (ACCs). Methods 20 cases of adrenocortical adenoma ACAA and 16 cases of ACCs were collected. The clinical, imaging, pathological and reticular fiber staining were analyzed, and the related literatures were reviewed. Results the median course of ACA was 21 months, the median course of ACA was 2. 6 cm ~ (-1) and the median diameter of tumor was 9. 5 cm ~ (-1). Distant metastasis was found in 9 cases. The tumor cells were nestled, thick beam arranged, cytoplasmic acidophilic or transparent. There were no capsule, sinus space, venous invasion, hemorrhage, necrosis, coarse collagen fibers. Weiss score was 鈮，

本文編號：1912243