Mesothelial cell inclusions in pelvic and para-aortic lymph nodes: a clinicopathologic analysis.
Mesothelial cell inclusions in pelvic and para-aortic lymph nodes: a clinicopathologic analysis.
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盆腔和主动脉旁淋巴结中的间皮细胞内含物：临床病理学分析。
DOI：
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发表时间：
2015
影响因子：
1.4
通讯作者：
S. Song
中科院分区：
文献类型：
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作者：
Hyunsoo Kim;G. Yoon;Y. Lee;Tae;C. Choi;Jeong;Byoung;D. Bae;S. Song
良性淋巴结包含物是妇科肿瘤手术中常见的，是转移性肿瘤的潜在模拟物。盆腔淋巴结中存在间皮细胞包涵体是非常罕见的。我们报告了10例卵巢肿瘤患者的临床病理特征，在盆腔和腹主动脉旁淋巴结窦中检测到间皮细胞包涵体。所有患者在淋巴结清扫时均伴有大量腹水和间皮细胞增生。在组织学上，结性间皮细胞主要在被膜下、小梁和髓窦内被识别。此外，结内和结外淋巴管也含有间皮细胞，证实了它们向结窦的淋巴转运模式。这一发现，以及间皮细胞增生和大量腹水表明，间皮细胞来源于反应性间皮细胞，并被移位到引流管中。本研究提示了淋巴转运机制的致病意义。结间皮细胞包涵体应与转移性肿瘤相区别，以避免已知肿瘤患者的不准确分期或隐匿性原发性肿瘤的假阴性诊断。除了常规染色切片外，通过免疫组化评价识别该实体对于防止转移癌或恶性间皮瘤的诊断是重要的。
Benign lymph node inclusions are commonly encountered during surgery for gynecologic neoplasms and are potential mimics of metastatic tumor. The presence of mesothelial cell inclusions in pelvic lymph nodes is extremely rare. We report the clinicopathologic features of 10 patients with ovarian tumors and mesothelial cell inclusions detected in the sinuses of pelvic and paraaortic lymph nodes. All patients had concurrent massive ascites and mesothelial cell hyperplasia at the time of lymph node dissection. Histologically, nodal mesothelial cells were identified predominantly within the subcapsular, trabecular and medullary sinuses. Moreover, intra- and extranodal lymphatics also contained mesothelial cells, confirming their mode of lymphatic transport to nodal sinuses. This finding, together with mesothelial cell hyperplasia and massive ascites suggest that mesothelial cells derive from reactive serosal mesothelium and are dislodged into draining lymphatics. This study indicated the pathogenic significance of the lymphatic transport mechanism. Nodal mesothelial cell inclusions should be distinguished from metastatic tumor to avoid inaccurate staging in a patient with a known tumor or the false negative diagnosis of an occult primary tumor. Recognition of this entity by immunohistochemical evaluation in addition to routinely stained sections is important to prevent a diagnosis of metastatic carcinoma or malignant mesothelioma.