袁菊 1吴晋蓉 1宋红杰 1余波 1陆珍凤 1姜少军 1周晓军1
作者信息
- 1. 南京大学医学院临床学院/南京军区南京总医院,南京,210002
- 折叠
摘要
Abstract
Purpose To study the clinicopathological features of malignant mesothelioma ( MM ) of the tunica vaginalis testis and provide useful imformation for the diagnosis and differential diagnosis of the tumor. Methods The morphology features of 3 malignant mesotheliomas of the tunica vaginalis testis were observed by gross observation, HE staining and electron microscopy. Immunohisto-chemisty was used to identify the immunophenotype. We also reviewed the literatures to further analyze the clinical manifestations, his-topathological features, immunohistochemisty, treatment and prognosis of MM. Results The three cases presented with scrotal masses with or without hydrocele. Macroscopically, the tumors are nodular, 0. 4 ~ 5. 0 cm in diameter. On the cut surface, the tumors are solid or cystic-solid, gray-white and texture tough. Microscopically, tumor cells arranged in varied patterns: nested, fascicular, storiform, solid sheets and glandular. Cytoplasm is pale or light. Nucleus is round, oval or irregular in shape, with prominent nucleoli, and mi-totic figures can be seen. Immunohistochemically, the tumor cells expressed CKpan, Calretinin, EMA, vimentin, calponin, CK7 and ViUin. Some of the tumor ceUs expressed CK5/6, WT-1, CEA, SMA, S-100, CD34 and CEA. While D2-40, HBME-1, CD30, desmin, CD117 and CK20 were negative. Proliferation index was 10% ~30%. By electron microscope, there were a lot of elongated microvilli on tumor cells surface. Intercellular junctions were also observed between tumor cells, including desmosome and junctional complex. There were a lot of cytofilaments in the cytoplasma, including tonofilaments and a certain amount of glycogen. Conclusions Malignant mesothelioma of the tunica vaginalis testis is rare, and it can be difficult to diagnosis clinically. The definite diagnosis requires light microscopy plus immunohistology and ( or ) electron microscopy. The differential diagnosis including mesothelial hyperplasi-a, adenomatoid tumor, adenocarcinoma of the rete testis, and papillary serous tumor. The patients after complete resection will have a better prognosis. The patient needs follow-up after surgery. Additional treatment with radiation and chemotherapy may also be used.关键词
恶性间皮瘤/睾丸鞘膜/鉴别诊断/超微结构Key words
malignant mesotheliom/ tunica vaginalis testis/ differential diagnosis/ ultrastructure分类
医药卫生
