【摘要】 目的探讨卵巢肿瘤继发腹膜黑色素沉着症的临床病理学特点和生物学行为。方法对3例卵巢肿瘤继发腹膜黑色素沉着症作了临床病理观察、免疫组化染色,并作了随访。结果3例患者年龄分别为17、29和23岁。例1卵巢囊性肿物,腹腔内多个大小不等的灰褐色肿物,切面囊内充满墨汁样液体。例2做了卵巢肿瘤姑息手术,术中检查腹腔和盆腔内有浓稠的墨汁样黑色素沉着。例3瘤体内有皮脂、毛发和充盈黑色液体的囊性结节。镜检:除例1伴发浆液性囊腺瘤,例3伴发囊性畸胎瘤外,3例病变基本相似,主要由胞质充满黑色素的细胞和胞质内无色素的细胞组成。绝大部分区域以前者占优势,纤维组织增生并纤维化,大量色素沉着使原有结构被掩盖。例1见少量破骨样多核巨细胞,腹膜和网膜内亦有大量黑色素沉着和纤维组织增生。例3Fontana染色阳性,普鲁士蓝染色阴性。例1免疫组化染色胞质内含有色素颗粒和无色素颗粒的细胞均有部分细胞HMB-45阳性,浆液性囊腺瘤内衬的上皮CK呈阳性,胞质内含有色素颗粒和无色素颗粒的细胞CK呈阴性,S-100、CD68、MC、CD34、ER、PR和NSE均阴性。结论腹膜黑色素沉着症为卵巢肿瘤和胃肠道发育畸形继发的一种良性病变。更多还原

【Abstract】 Purpose To study the etiology and clinicopathologic features and biological behavior of peritoneal melanosis combined with ovarian tumors.Methods Three cases of peritoneal melanosis combined with ovarian tumors were studied by the clinical and pathological features,immunohistochemical stain and clinical follow-up.Results Three cases of peritoneal melanosis were 17 and 29 and 23 years old,respectively.The resected specimen consisted of ovarian multiocuilar cysts and the nodes of peritonum and omentum containing black pigmented fluid in case 1.A palliatively excised mass with dark black pigmentation was found,and the peritonum and omentum were stained with dark black color in case 2.The resected ovarian tumor contained the sebaceous material and hair as well as cystic nodes with dark black fluid.Microscopically,the ovarian mass showed the histological changes of serous cystadenoma lined by a cubical layer of epithelial cells in case 1,and the benign teratoma was diagnosed in case 3.There were similar lesions in the 3 cases,which consisted of the cells containing pigmented granules and non-pigmented granules in the cytoplasm.The most of the cells was full of coarsely granular pigmentation in the cytoplasm.A large number of pigmented cells were found in the peritonum and omentum,especially around the vessels.There were band-like infiltrations of pigmented ovoid to spindle cells localized in the ovarian mass,the peritonum and omentum.Dark black pigments were stained with the Fontana-Masson method and the pigments did not stain with Perl’s Prussian blue.Immunohistochemistry showed the positive staining for HBM-45,but negative for S-100,CD68,MC,CD34,ER,PR and NSE.CK was expressed in the lining epithelial cells of the ovarian cystadenoma.Conclusion Peritoneal melanosis is a benign lesion secondary to ovarian tumors and enteric dupication cyst or gastric triplication.更多还原