卵巢病变的组织形态学研究,重点是罕见实体-一项描述性研究

S. Surapaneni, Vandana Gangadharan, Harika Pentakota, Krishna Kumari Sala
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引用次数: 0

摘要

卵巢是位于子宫两侧的双侧器官。非肿瘤性和肿瘤性病变可发生于所有年龄组,并可表现出相似的临床和放射学特征。组织病理学仍然是诊断和分类这些病变的金标准。目的:探讨卵巢病变患病率与年龄及临床表现的关系。肿瘤病变将按照世界卫生组织的指导方针进行组织学分类。本研究结果将与其他研究结果进行比较。材料和方法:本研究是一项观察性研究,于2018年6月至2021年11月在印度安得拉邦维沙卡帕特南Sangivalasa的NRI医学科学研究所病理学系进行的所有卵巢病变。标本作为卵巢肿块单独接受,或联合子宫切除单侧或双侧输卵管卵巢切除术。从病历中获取相关临床资料。组织经自动组织处理机处理,制作石蜡块,切片用红木精和伊红(H&E)染色,在显微镜下观察。病变分为非肿瘤性和肿瘤性。肿瘤病变根据最新的2020年世界卫生组织(WHO)指南进行分类。各种病变发生率以百分比表示。结果:共研究标本119例。部分双侧卵巢,18例双侧卵巢有不同的非肿瘤性病变。非肿瘤性病变80例(60.60%),肿瘤性病变52例(39.39%)。5例扭转由于缺乏可行的组织学特征,无法区分为肿瘤或非肿瘤。非肿瘤性病变多见于31-50岁年龄组。良性肿瘤多见于41 ~ 50岁年龄组。恶性肿瘤在围绝经期和绝经后年龄组更为常见。最常见的非肿瘤性病变为卵泡囊肿39例(48.75%),其次为黄体囊肿26例(32.5%),囊性卵泡13例(16.25%),子宫内膜异位症2例(2.5%)。其中良性47例(90.38%),交界性2例(3.84%),恶性3例(5.76%)。表面上皮肿瘤42例(80.76%),生殖细胞肿瘤6例(11.53%),性索间质肿瘤4例(7.69%)。结论:非肿瘤性病变与肿瘤性病变具有相似的临床和影像学表现,必须进行组织病理学鉴别。非肿瘤性病变在本研究中更为常见。在所有肿瘤中,良性肿瘤最为常见,而表面上皮性肿瘤最为常见。卵巢扭转、浆液性囊腺瘤、非典型子宫内膜样瘤和颗粒细胞瘤是研究中罕见的实体。肿瘤分类有助于更好地管理患者。
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Histomorphological Study of Ovarian Lesions with Emphasis on Rare Entities- A Descriptive Study
Introduction: The ovaries are bilateral organs on either side of the uterus. Non neoplastic and neoplastic lesions occur in all age groups and can present with similar clinical and radiological features. Histopathology remains the gold standard for diagnosing and categorising these lesions. Aim: To study the prevalence of ovarian lesions in relation to age and clinical findings. Neoplastic lesions will be histologically classified as per World Health Organisation guidelines. Findings in this study will be compared with that in other studies. Materials and Methods: This is an observational study of all ovarian lesions undertaken in the Department of pathology in NRI Institute of Medical Sciences, Sangivalasa, Vishakhapatnam, Andhra Pradesh, India, from June 2018 to November 2021. Specimens were received as ovarian masses alone, or in combination with hysterectomy with either unilateral or bilateral salpingo- oophorectomy. Relevant clinical information was obtained from the records. The tissues were processed by using an automatic tissue processor, paraffin blocks were made and sections cut were stained with Haematoxylin and Eosin(H&E) and examined under the microscope. The lesions were categorised as non neoplastic and neoplastic. The neoplastic lesions were classified according to the latest 2020 World Health Organisation (WHO) guidelines. Incidence of various lesions was expressed in percentage. Results: A total of 119 specimens were studied. Some of the specimens had bilateral ovaries and the second ovary had a different nonneoplastic lesion in 18 cases. 80 (60.60%) were nonneoplastic lesions and 52 (39.39%) were neoplastic lesions. 5 cases of torsion could not be classified into neoplastic or non-neoplastic due to lack of viable histological features. Non neoplastic lesions were more common in the 31-50 years age group. Benign neoplasms were common in 41-50 years age group. Malignant tumours were more common in the perimenopausal and postmenopausal age group. The most common non neoplastic lesion were 39 cases (48.75%) of follicular cyst followed by 26 cases (32.5%) of corpus luteal cyst, 13 cases (16.25%) of cystic follicles and 2 cases (2.5%) of endometriotic lesions. Of the neoplastic lesions, 47 cases (90.38%) were benign, 2 cases (3.84%) were borderline and 3 cases (5.76%) were malignant tumours. Surface epithelial tumours were 42 cases (80.76%), followed by 6 cases (11.53%) of germ cell tumours and 4 cases (7.69%) of sex cord stromal tumours. Conclusion: Non neoplastic lesions and neoplastic lesions present with similar clinical and radiologic picture and must be differentiated histopathologically. Non neoplastic lesions were more common in the present study. Among the neoplasms, benign tumours were more common and surface epithelial tumours were more common than any other category. Torsion ovary, Seromucinous cystadenoma, atypical endometrioid tumor and granulosa cell tumor were some rare entities that were encountered in the study. Classifying tumours helps in better patient management.
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