Ovarian small cell carcinoma of pulmonary type appearing in ante-mortem ascites: An autopsy case and review of the literature
Ovarian small cell carcinoma of pulmonary type appearing in ante-mortem ascites: An autopsy case and review of the literature
复制标题
生前腹水中出现肺型卵巢小细胞癌一例尸检及文献复习
DOI：
10.1016/j.ehpc.2015.02.003
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发表时间：
2015
影响因子：
--
通讯作者：
Masahiko Kuroda
中科院分区：
文献类型：
--
作者：
Hirotsugu Hashimoto;Atsushi Kurata;Koji Fujita;Hideto Shimada;Takeshi Nagai;Hajime Horiuchi;Masahiko Kuroda
卵巢肺型小细胞癌（OSCCPT）是一种极为罕见的侵袭性疾病。然而，腹水细胞学对OSCCPT的诊断意义尚未得到证实。在这里，我们报告的诊断这种癌在尸检病例与死前细胞学腹水。一位75岁的女性通过放射影像学检查发现双侧卵巢癌。虽然计划进行手术，但几周后发现大量腹水。腹水经腹腔穿刺清除，细胞学诊断为癌，怀疑腺癌。几天后，她去世了。从尸检样本中，我们诊断该病例为双侧OSCCPT，免疫组织化学显示神经内分泌分化。我们回顾了死前腹水的细胞学检查，发现分散的小的非典型细胞。腹水细胞块的免疫细胞化学研究显示非典型细胞的神经内分泌分化与尸检标本相同。由于OSCCPT的非典型小细胞常与其他组织学肿瘤成分同时存在，因此，通过腹水细胞学检查准确诊断OSCCPT，建议在制备过程中仔细筛选所有细胞。
Ovarian small cell carcinoma of pulmonary type (OSCCPT) is an extremely rare and aggressive disease. The diagnostic significance of cytology of ascites for OSCCPT, however, has not been shown so far. Here, we report the diagnosis of this carcinoma in an autopsy case with ante-mortem cytology of ascites. A 75 year-old woman was detected with bilateral ovarian cancer by radiological imaging. Although operation was planned, massive ascites was discovered a few weeks later. Ascites was removed with abdominocentesis, which cytologically diagnosed presence of carcinoma, suspicious of adenocarcinoma. A few days later, she died. From autopsy samples, we diagnosed this case as bilateral OSCCPT, showing neuroendocrine differentiation by immunohistochemistry. We reviewed ante-mortem cytology of ascites and found scattered small atypical cells. Immunocytochemical study of the cell block of the ascites showed neuroendocrine differentiation of the atypical cells in an identical manner as the autopsy specimens. Since small atypical cells of OSCCPT often exist with other histological tumor components, careful screening of all cells on the preparation is advisable to accurately diagnose OSCCPT by cytology of ascites.