Ovarian Epithelial Inclusions With Mucinous Differentiation: A Clinicopathologic Study of 42 Cases
Ovarian Epithelial Inclusions With Mucinous Differentiation: A Clinicopathologic Study of 42 Cases
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伴有粘液分化的卵巢上皮包涵体42例临床病理分析
DOI：
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发表时间：
2017
影响因子：
2.4
通讯作者：
J. Krishnan
中科院分区：
文献类型：
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作者：
J. Seidman;J. Krishnan
卵巢上皮内含物内衬粘液上皮是罕见的，来源不明。在42名妇女中研究了含有这种夹杂物的卵巢。包涵体可分为3组：衬有典型纤毛形态但部分或全部衬细胞中有明显嗜碱性细胞质粘蛋白的浆液性上皮，衬有典型粘液性上皮的浆液性上皮，衬有典型粘液性上皮和浆液性上皮组合的浆液性上皮。患者平均年龄为61.5岁。27例为纯粘液性包涵体，20例为浆液性包涵体伴胞浆粘液性包涵体，10例为混合型包涵体。3种类型的夹杂物均见于1例患者。两种类型的夹杂物中发现13。4例患者有相关的粘液性肿瘤（1例粘液性囊腺瘤，1例非典型增生性血清粘液性肿瘤和2例血清粘液性囊腺瘤），11例患者（26%）有子宫内膜异位症。4例患者（9.5%）的输卵管也显示粘液性化生;这与我们先前报道的来自同一人群的输卵管炎系列中的3.1%没有显著差异。这些结果表明，粘液包涵体可能出现作为一个直接化生变化的浆液型夹杂物。卵巢皮质粘液性内含物的其他可能来源包括子宫内膜异位症和Brenner（移行细胞）巢。这种内含物是否能像布伦纳瘤和成熟囊性畸胎瘤一样成为粘液性卵巢肿瘤的来源尚不清楚，可能需要进一步研究。
Ovarian epithelial inclusions lined by mucinous epithelium are rare and of uncertain origin. Ovaries containing such inclusions were studied in 42 women. The inclusions were divided into 3 groups: serous epithelial lined with typical ciliated morphology but with distinct basophilic cytoplasmic mucin in some or all of the lining cells, those lined by typical mucinous epithelium, and those lined by a combination of typical mucinous epithelium and serous epithelium. The mean patient age was 61.5 years. Pure mucinous inclusions were found in 27 patients, serous-type inclusions with cytoplasmic mucin in 20, and mixed type in 10. All 3 types of inclusions were found in 1 patient. Two types of inclusions were found in 13. Four patients had associated mucinous neoplasms (1 mucinous cystadenoma, 1 atypical proliferative seromucinous tumor, and 2 seromucinous cystadenomas), and 11 patients (26%) had endometriosis. The fallopian tubes in 4 patients (9.5%) also displayed mucinous metaplasia; this was not significantly different from the 3.1% we found in our previously reported series of unselected tubes from the same population. These findings suggest that mucinous inclusions may arise as a direct metaplastic change in serous-type inclusions. Other possible origins of mucinous inclusions in the ovarian cortex include endometriosis and Brenner (transitional cell) nests. Whether such inclusions can be a source of mucinous ovarian neoplasms as are Brenner tumors and mature cystic teratomas is unknown and may warrant further investigation.