【摘要】 目的探讨儿童卵黄囊瘤的临床病理特征、病理诊断与鉴别诊断。方法收集广州市妇女儿童医疗中心2007年6月至2017年6月的儿童卵黄囊瘤191例。分析其临床病理特征,并复习相关文献。结果发病年龄多为4岁以下。发病部位以性腺为主共107例(56%),其中睾丸为最多发生部位共96例,卵巢11例;发病部位在性腺外84例(44%),其中尾骶部35例(18.1%),阴道16例(8.3%),胸部9例(4.6%),其他部位24例。发生部位在性腺与性腺外的比例为1.27∶1。卵黄囊瘤的组织学改变呈多样性,其中单纯的卵黄囊瘤156例(81.7%),合并其它生殖细胞肿瘤35例(18.3%)。结论儿童卵黄囊瘤组织学变化多样,发病部位和临床症状均表现出明显的多样化,儿童卵黄囊瘤可广泛发生在儿童及青少年身体的各个部位,除了最常见的性腺睾丸外,也可发生于颅内、脊髓、骶尾部、纵隔、腹膜后、头颈部等部位。诊断中需要掌握卵黄囊瘤的不同形态学表现,注意区分混合性生殖细胞肿瘤,辨别多种成份的存在。合理应用免疫组化染色有助于它们之间的鉴别,以更好地为临床诊治服务。更多还原

【Abstract】 Objective To explore the clinicopathological features, pathological diagnosis and differential diagnosis of yolk sac tumor in children. Methods From June 2007 to June 2017 totally 191 children with yolk sac tumors were collected in Guangzhou Women and Children Medical Center. Their clinicopathological features were analyzed and relevant literatures were reviewed. Results The age of onset was usually under 4. There were 107 cases(56%) with pathogenic site of gonadal gland, including 96 cases in testicles and 11 cases in ovary. The pathogenic site was not in gonad in 84 cases(44%), including 35 cases(18.1%) in caudal region, 16 cases(8.3%) in vagina, 9 cases(4.6%) in chest and 24 cases in other site. The ratio of the cases with gonads as pathogenic site to those whose site was outside was 1.27:1. Histological changes were diverse. There were 156 cases of simple yolk sac tumor(81.7%), 35 cases combined with other germ cell tumors(18.3%). Conclusion The histological changes of yolk sac tumor in children are diverse, and the location and clinical symptoms are obviously diversified. It can occur in all parts of children and adolescents. In addition to the most common gonadal testicles, they can also occur in skull, spinal cord, sacral tail, mediastinum, retroperitoneal, head and neck. Different morphological manifestations of yolk sac tumor should be mastered in diagnosis. Attention should be paid to the differentiation of mixed germ cell tumors, the existence of multiple components, and the rational application of immunohistochemical staining to help them identify better for clinical diagnosis and treatment.更多还原