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1、卵巢表面恶性胃肠道外间质瘤临床病理探【摘要】目的：报道1例发生于卵巢表面的恶性胃肠道外间质瘤，并分析其临床病理特征、诊断与鉴别诊断等。方法：复习原切片和临床资料，经HE及免疫组织化学染色确诊,并复习文献。结果：女患者，44岁，肿瘤位于左侧卵巢表面，大小1.9x1.3x1.1cm;肿瘤主要由梭形、上皮样细胞组成，胞质丰富，嗜酸性或淡嗜酸性，可见核仁，并见坏死及核分裂像。术中诊断为：卵巢梭形细胞恶性肿瘤（恶性间皮瘤可能）。经复习原切片并作免疫组织化学染色：Vimentin.CD117和CD34均阳性，calretinin.CD31.CK、S-100.NSE、Syn、SMA和desmin均阴性，修
2、正诊断为：卵巢恶性胃肠道外间质瘤。结论：胃肠道外间质瘤具有平滑肌瘤、神经鞘瘤和神经源性分化的特征，发生于女性生殖系统及其附件者罕见，易误诊为其它妇科肿瘤，临床上应与卵巢癌鉴别,其组织形态应与平滑肌瘤、神经鞘瘤、炎性肌纤维母细胞瘤、脂肪肉瘤、恶性间皮瘤、腹内纤维瘤病及孤立性纤维瘤等鉴别。【关键词】胃肠道外间质瘤卵巢免疫组织化学ExtragastrointestinalmalignantstromaltumorlocatedinovarysurfacereportofonecaseandreviewofliteratureFangPing,etal【Abstract]Objective:Tore
3、portacaseofextragastrointestinalstromaltumors(EGIST)arisingfromovary,andanalyzeitsclinicopathologiccharacteristics,diagnosisanddifferentialdiagnosis・Methods:TheclinicaldataandtheHEslidesofthiscasewerereviewed,andre-diagnosedbyimmunohistochemicalstain.AndtheliteraturesofEGISTwerereviewed・Results:Thi
4、sfemalepatientwas44year-oldandthetumourlocatedinthesurfaceoftheleftovary,measuring1.9^1.3><1.1cminsize.Histologically,thetumorconsistedofspindleorepithelioidcellswithricheosinophilicorlight-eosinophiliccytoplasm,ucleoliwereclear,necrosisandmitosiscouldbeseen.Theformerdiagnosiswasspindlecellmalignan
5、ttumouroftheleftovary(withthepossibilityofmalignantmesothelioma).ImmunohistochemicalassayshowedthetumorcellswerepositiveforVimentin,CD117andCD34,butwerenegativeforcalretinin,CD31,CK,S-100,NSE,Syn,SMAandDesmin.ThediagnosiswasmodifiedasmalignantEGISTofovary.Conclusion:EGISTmayhavesamemorphologicalche
6、ractersticsofleiomyoma,schwannomaandneurogenictumour.Itrarelyoccuredinovary,andcouldbemisdiagnosedasotherovarytumors,soitshouldbedifferentiatedfromothertumorsofovaryclinically,Histopathologically,differentialdiagnosisofEGISTofovaryineludeleiomyoma,neurilemmoma,inflammatorymyofibroblastoma,adiposesa
7、rcoma,malignantmesothelioma,fibromatosisandsolitaryfibroustumor.【Keywords]Extragastrointestinalstromaltumors(EGIST)OvaryImmunohistrochemistry胃肠道间质瘤(Gastrointestinalstromaltumors,GIST)是起源于Cajal细胞的间叶性肿瘤，常发生于胃
