Adenomatoid tumor of testis
赵明 刘正智
更新时间:2020-07-25 18:22:00
同义词(或曾用名):良性间皮肿瘤
概述:
发病部位:睾丸附件、附睾
诊断要点:
1,多发生于30-50岁成年男性;
2,大体上表现为睾丸旁界限清楚的孤立性实性结节,一般较精原细胞瘤的质地要硬,瘤体直径通常<2cm,偶可达5cm;
3. 多见于附睾的上极或下极,少数可发生于睾丸鞘膜或精索内;
4. 瘤细胞呈小管状、条索状或小巢状排列,瘤细胞大小较一致、立方状,胞浆中等量至丰富,嗜酸性,常见胞浆内空泡以至瘤细胞呈印戒细胞样或脂肪母细胞样,部分胞浆内可见黏液蓄积;
5,其他组织学特征包括淋巴管瘤样、腺管状、囊性、强嗜酸性性或实性结构;
6,间质为多少不等的纤维性,部分呈平滑肌瘤样间质;
7,病灶周边常见淋巴细胞聚集
免疫组织化学染色:
分子标记:
鉴别诊断:
转移性低分化腺癌:可见异型性,收缩裂隙和核分裂象等
硬化性Sertoli细胞瘤:位于睾丸实质内,免疫组化染色核表达b-catenin和cyclinD1
精原细胞瘤:位于睾丸实质内,表达SALL4和OCT4
预后:
治疗:
参考文献:
Sangoi AR, McKenney JK, Schwartz EJ, Rouse RV, Longacre TA. Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases. Mod Pathol. 2009;22(9):1228-1235.
Goode B, Joseph NM, Stevers M, et al. Adenomatoid tumors of the male and female genital tract are defined by TRAF7 mutations that drive aberrant NF-kB pathway activation. Mod Pathol. 2018;31(4):660-673.
Ramsey ML, Yuh BJ, Johnson MT, Yeldandi AV, Zynger DL. Carbonic anhydrase IX is expressed in mesothelioma and metastatic clear cell renal cell carcinoma of the lung. Virchows Arch. 2012;460(1):89-93.
Amin MB. Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors. Mod Pathol. 2005;18 Suppl 2:S131-S145.