【衡道丨干货】WHO图注英⽂学习⼿帐 (卵巢透明细胞肿瘤与卵巢浆黏液性肿瘤篇)

衡道病理特邀撰稿作者翻译了WHO部分图⽚的图注，并用手帐的⽅式进行中英对照，且通过不同颜色的划线将晦涩难懂的英文单词与中⽂翻译同时标注，希望对专业英文的学习有所帮助。上一期分享了卵巢子宫内膜样肿瘤，本期将带来卵巢透明细胞肿瘤与卵巢浆黏液性肿瘤。由于本篇目的以英文学习为主，篇幅有限，故未对各个疾病进行详细阐述。 全部图片均来自WHO ， 若有不恰当之处，还请评论区指正。 

WHO图注英文学习手帐

一、透明细胞肿瘤

①Clear cell cystadenoma and adenofibroma 透明细胞囊腺瘤和腺纤维瘤  Definition

Clear cell cystadenoma and adenofibroma are benign epithelial tumours composed of small, round glands containing bland clear or oxyphilic cells with a variable fibromatous stroma.

定义

透明细胞囊腺瘤和腺纤维瘤是良性上皮肿瘤，由小而圆的腺体组成，腺体衬覆温和的透明或嗜酸性细胞，并有不同程度的纤维瘤性间质。

ICD-O coding

8443/0 Clear cell cystadenoma

8313/0 Clear cell cystadenofibroma

ICD-O编码

8443/0 透明细胞囊腺瘤

8313/0 透明细胞腺纤维瘤 

Essential and desirable diagnostic criteria

Essential: cystic/adenofibromatous clear cell tumour lacking nuclear atypia and stromal invasion.

必须和理想的诊断标准

必须:囊性/腺纤维瘤性透明细胞肿瘤，缺乏核异型性和间质浸润。

Fig. 1.49 Clear cell adenofibroma. The cells show no significantnuclear atypia.

图1.49透明细胞腺纤维瘤。细胞无明显核异型性。

②Clear cell borderline tumour  透明细胞交界性肿瘤  Definition  

Clear cell borderline tumour (CCBT) is an adenofibromatous clear cell tumour with glandular crowding and low-grade nuclear atypia but no stromal invasion.  

定义

透明细胞交界性肿瘤(CCBT)是一种腺纤维性透明细胞肿瘤，腺体拥挤，低级别核异型性，但无间质浸润。

ICD-O coding  

8313/1 Clear cell borderline tumour  

ICD-O编码

8313/1 透明细胞交界性肿瘤

Essential and desirable diagnostic criteria  

Essential: adenofibromatous clear cell tumour with glandular crowding, nuclear atypia, and a low mitotic count; no stromal invasion or papillary architecture.  

必须和理想的诊断标准

必须:腺纤维瘤性透明细胞肿瘤，腺体拥挤，核异型性可见，核分裂象计数低；无间质浸润或乳头状结构。

Fig. 1.50 Clear cell borderline tumour. Focally crowded nests and glands with clear cells showing low-grade nuclear atypia and prominent nucleoli in a fibromatous stroma.

图1.50透明细胞交界性肿瘤。在纤维瘤性间质中可见局灶性密集的细胞巢和腺体，胞质透亮、低级别核异型性、核仁突出。

Fig. 1.51 Clear cell borderline tumour. Peritoneal fluid cytology. Note the epithelial aggregates with nuclear enlargement and overlapping, as well as conspicuousnucleoli.

图1.51透明细胞交界性肿瘤。腹水细胞学。注意上皮样细胞聚集，核增大、重叠，以及核仁明显。

③Clear cell carcinoma of the ovary  卵巢透明细胞癌Definition

Clear cell carcinoma (CCC) is composed of clear, eosinophilic, and hobnailcells, with tubulocystic, papillary, and solid architecture.

定义

透明细胞癌(CCC)由透明细胞、嗜酸性细胞和鞋钉样细胞组成，呈管囊状、乳头状和实性结构。

ICD-O coding

8310/3 Clear cell adenocarcinoma NOS

ICD-O编码

8310/3透明细胞腺癌NOS

Essential and desirable diagnostic criteria

Essential: a combinationof architectural patterns (tubulocystic, papillary, and solid architecture) with flat or cuboidal cells (clear, eosinophilic, hobnail) having uniform nuclear features overall and low mitoticcounts.

Desirable: associated clear cell adenofibroma; HNF1B and napsin A positivity; WT1 and PR negativity.

必须和理想的诊断标准

必须:不同组织学（管囊状、乳头状、实性）结构模式的组合，细胞扁平或立方状(透明、嗜酸性、鞋钉状)，整体核特征一致，核分裂数低。

理想:与透明细胞腺纤维瘤；HNF1B和napsin A阳性；WT1和PR阴性。

Fig. 1.52 Clear cell carcinoma. A Neoplastic glands infiltrating fibromatous stroma. B Tubules lined by a single layer of hobnail cells with eosinophiliccytoplasm.

图1.52透明细胞癌。A肿瘤性腺体在纤维瘤性间质中浸润性生长。B小管衬覆单层鞋钉样细胞，胞浆嗜酸性。

Fig.1.53 Clear cell carcinoma. A Papillary architecture with simple papillae showing stromal hyalinization. B Papillae lined by a single layer of cuboidal cells with clear cytoplasm.

图1.53透明细胞癌。A简单的乳头状结构伴间质玻璃样变性。B乳头衬覆单层立方细胞，胞质透亮。

Fig. 1.54 Clear cell carcinoma. A Solid architecture composed of sheets of clear cells separated by delicate septa. B Sheets of polyhedral clear cells with eccentrically placed nuclei. Hyaline bodies are present.

图1.54透明细胞癌。A一种由成片的透明细胞组成、纤细的间质分隔的实性结构。B成片的多角形透明细胞，核偏位。可见透明小体。

Fig. 1.55 Clear cell carcinoma, tubulocystic pattern. Cystic glands are lined by a single layer of cuboidal,flattened, and hobnail cells with clear cytoplasm.

图1.55透明细胞癌，管囊状结构。囊壁被覆单层立方、扁平、鞋钉状细胞，胞质透明。

二、浆黏液性肿瘤

①Seromucinous cystadenoma and adenofibroma  浆黏液性囊腺瘤和腺纤维瘤Definition  

Seromucinous cystadenoma is a benign cystic neoplasm composed of glands and cysts lined by an admixture of bland Müllerian-type epithelia. Seromucinous adenofibroma differs from cystadenoma in that it has a prominent fibromatous stromal component.  

定义

浆黏液性囊腺瘤是一种良性的囊性肿瘤，由腺体和囊腔组成，衬覆温和的混合性苗勒氏上皮。浆黏液性腺纤维瘤不同于囊腺瘤，它有明显的纤维瘤性间质。

ICD-O coding  

8474/0 Seromucinous cystadenoma  

9014/0 Seromucinous adenofibroma  

ICD-O编码

8474/0 浆黏液性囊腺瘤

9014/0 浆黏液性腺纤维瘤

Essential and desirable diagnostic criteria  

Essential: glands within a fibromatous stroma or cysts lined by an admixture of Müllerian-type epithelia with bland cytological features.  

必须和理想的诊断标准

必须：位于纤维瘤性间质内的腺体或囊肿衬覆混合性苗勒氏上皮细胞，细胞形态温和。

Fig. 1.56 Seromucinous cystadenoma.

A Benign seromucinous tumour with cysts lined by mucinous epithelium (right) and attenuated serous-type epithelium (left).

B Benign seromucinous tumour with cysts lined by mucinous epithelium and serous-type epithelium.

图1.56浆黏液性囊腺瘤。

A良性浆黏液性肿瘤，囊肿衬覆黏液性上皮(右)和扁平的浆液性上皮(左)。

B良性浆黏液性肿瘤，囊肿衬覆黏液性上皮和浆液性上皮。

②Seromucinous borderline tumour  浆黏液性交界性肿瘤  Definition  

Seromucinous borderline tumour is an architecturally complexpapillaryneoplasm composed of an admixture of Mülleriantype epithelia, lacking confluent or destructive invasion.  

定义

浆黏液性交界性肿瘤是一种结构复杂的乳头状肿瘤，由混合性苗勒氏上皮组成，缺乏融合性或破坏性浸润。

ICD-O coding  

8474/1 Seromucinous borderline tumour  

ICD-O编码

浆黏液性交界性肿瘤

Essential and desirable diagnostic criteria  

Essential: papillae exhibiting hierarchical branching with oedematous and fibrous stromal cores lined by an admixture of Müllerian cell types exhibiting proliferation, but without stromal invasion.  

Desirable: evidence of endometriosis.  

必须和理想的诊断标准

必须:乳头有复杂分支，伴水肿和纤维性轴心，衬覆增生的混合性苗勒氏细胞，但不伴有间质浸润。

理想:存在子宫内膜异位症。

Fig.1.57 Seromucinous borderline tumour. A Plump papillae with a neutrophilic infiltrate. Epithelial tufting. B The epithelial lining consists of Müllerian mucinous cells. A few neutrophils are present in the stroma. C Admixture of Müllerian-type epithelia with endocervical cells, squamousdifferentiation, and nondescript eosinophilic cells.

图1.57浆黏液性交界性肿瘤。A膨大的乳头有中性粒细胞浸润。有上皮细胞簇。B上皮衬覆黏液性苗勒氏上皮。间质中有少量中性粒细胞浸润。C 混合苗勒氏上皮细胞、宫颈管型细胞、鳞状分化细胞和非特殊性嗜酸性细胞。

③浆黏液性癌

Seromucinous carcinoma was included in the previous classification and was defined as a carcinoma composed predominantly of serous and endocervical-type mucinous epithelium, often with foci containing clear cells and areas of endometrioid and squamous differentiation . It has been removed from this classification because this is a poorly reproducible diagnosis and there is significant morphological overlap with other tumour types, especially endometrioid carcinoma. Immunohistochemical and molecular studies have also suggested that most cases represent unusual morphological patterns of endometrioid carcinoma; therefore, seromucinous carcinoma is now considered a subtype of endometrioid carcinoma and is discussed in that section.

浆黏液性癌在上一版的分类中已包括，定义为主要由浆液性和宫颈内型黏液上皮组成的癌，通常病灶含有透明细胞、子宫内膜样和鳞状分化区。这一版分类将其删除，因为这是一个重复性差的诊断，并且它的形态学与其他肿瘤类型有重叠，特别是子宫内膜样癌。免疫组化和分子研究也表明，大多数病例表现为子宫内膜样癌的少见形态；因此，浆黏液性癌现在被认为是子宫内膜样癌的一种亚型，并在该部分进行讨论。

整理：南瓜子儿

审核：樊月

设计：鹏飞

编辑：雅芸

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