【摘要】 目的 探讨卵巢两性母细胞瘤的临床及病理组织学特征。 方法 观察总结2004年3月-2008年3月6例卵巢两性母细胞瘤的临床及病理学特征，以及免疫组化染色结果。 结果 患者以月经紊乱、闭经、绝经后阴道出血为主要临床表现。肿瘤含两种成分，即颗粒细胞和Sertoli-Leydig细胞，两者均呈成熟性的组织学形态，1例伴有异源性分化成分。6例肿瘤呈α-inhibin和vimentin强阳性，3例呈CD99阳性，5例呈calretinin阳性，2例的Sertoli细胞呈CK阳性。4例患者有随访资料，随访期14～60个月，均无瘤存活。 结论 两性母细胞瘤以内分泌异常相关症状为主要临床表现，大部分患者诊断时处于临床1期，预后较好。对诊断为两性母细胞瘤的患者应进行长期的临床随访。【Abstract】 Objective To observe the clinical pathologic and immunophenotypic features of gynandroblastoma. Methods The pathologic samples of six patients with gynandroblastoma from March 2004 to March 2008 were observed and analyzed. Immuohistochemistry staining was performed by SP method using antibodies of α-inhibin,CD99,Vimentin,Calretinin,CK,EMA. Results The main clinical features included menstrual disorders, amenorrhea, and postmenopausal bleeding. The tumor was composed of ranulose cells and Sertoli cells, both of which were well differentiated. Strongly positive expression of α-inhibin and vimentin was found in all the patients, while CD99 (+) was in three, calretinin (+) was in five, and CK (+) of Sertoli cells was in two. Four patients were followed up for 14-60 months and all were tumor free. Conclusion The main clinical features of gynandroblastoma are estrogenic or androgenic manifestations. Nearly all the patients are diagnosed in stage 1 and have a good prognosis. Patients with gynandroblastoma should be followed up for a long period.
Objective To investigate the value of a new double action MR contrast agent——Gd-BOPTA in the diagnosis of focal nodular hyperplasia (FNH) of the liver with correlation of pathology. Methods Dedicated MRI scans were performed for 5 patients suspected to have liver FNH on clinical and imaging basis (six lesions). The MR imaging protocol included axial T1W and T2W plain scan, coronal T2 weighted imaging, 3D MRCP, Gd-BOPTA enhanced LAVA dynamic tri-phasic acquisitions (scanning at 15 s, 55 s and 90 s respectively), enhanced 2D T1W scan, enhanced LAVA in delay phase (at 5 and 10 min) and in the hepatobiliary phase (at 40 and 80 min). The imaging features on each MR sequence were compared with surgical and pathological findings. Results Six lesions in 5 FNH patients were all correctly diagnosed (5 conformed by surgery and 1 by needle biopsy). ①The hemodynamic phase: The parenchyma of 5 lesions were markedly enhanced in the arterial phase, being isointense or slight hypointense in both the portal venous and delay phases, while 1 lesion was isointense in all phases except being slight hyperintense in the arterial phase; The central scar of 5 lesions were not enhanced in the dynamic phase, but showed delayed enhancement. ②The hepatobiliary (excretory) phase: The parenchyma of all 6 lesions were slight hyperintense or isointense, and tree-like bile ducts with hyperintensity were seen within one lesion. The scar showed no enhancement. ③Pathology: The parenchyma was consisted of disarranged normal hepatocytes but with cytoedema, lack of portal tracts and cholestatic change. The central scar showed rich fibrous tissue, a very thick-walled arteriole, proliferative bile ducts, infiltration of inflammatory cells and myxomatous changes. Conclusion As a dual-phase MR contrast agent capable of depicting both the hemodynamic attributes and hepatobiliary excretion, Gd-BOPTA enhanced MRI can reflect the pathological features of FNH and reach a high diagnostic accuracy.