【衡道丨干货】WHO图注英文学习手帐 (卵巢其他上皮性肿瘤篇)

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Brenner肿瘤，本期将带来卵巢其他癌、间叶性肿瘤与混合性上皮和间叶肿瘤。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

其他癌  

一、Mesonephric-like adenocarcinoma  

中肾样腺癌

Definition  

Mesonephric-like adenocarcinoma is an adenocarcinoma displaying mesonephric differentiation.

定义

中肾样腺癌是一种显示中肾分化的腺癌。

ICD-O coding  

9111/3 Mesonephric-like adenocarcinoma

ICD-O编码

9111/3中肾样腺癌

Essential and desirable diagnostic criteria  

Essential: histological features prototypical for mesonephric carcinoma.  

Desirable: positivity for GATA3 or TTF1; negativity for ER and PR.

必需和理想的诊断标准

必需:中肾癌的组织学特征。

理想:GATA3或TTF1阳性;ER和PR阴性。

Fig.1.63 Ovarian mesonephric-like carcinoma. Varied architectural patterns including tubules lined by cuboidal cells and filled with eosinophilic colloid-like material, as well asangulated glands and papillary structures lined by columnar cells.  

Fig.1.63卵巢中肾样腺癌。不同的结构模式，包括衬覆立方细胞、充满嗜酸性胶样物的小管，以及衬覆柱状细胞的成角腺体和乳头状结构。

Fig.1.64 Ovarian mesonephric-like carcinoma. Examples showing tubular (A), mixed ductal and papillary (B), and mixed tubular and solid (C) patterns.  

图1.64卵巢中肾样腺癌。管状结构(A)，导管状和乳头状混合生长模式(B)，管状和实性结构混合生长模式(C)。

Fig. 1.65 Ovarian mesonephric-like carcinoma. GATA3 immunostaining is positive.  

1.65卵巢中肾样腺癌。GATA3染色阳性

二、Undifferentiated and dedifferentiated carcinomas of the ovary  

卵巢未分化和去分化癌  

Definition  

Undifferentiated carcinoma is a malignant epithelial tumour lacking overt evidence of a specific line of differentiation. Dedifferentiated carcinoma is composed of an undifferentiated carcinoma and a differentiated component.

定义

未分化癌是一种恶性上皮性肿瘤，缺乏明显的特异性分化证据。去分化癌由未分化癌和分化成分组成。

ICD-O coding  

8020/3 Carcinoma, undifferentiated, Nos  

8020/3 Dedifferentiated carcinoma

ICD-O编码

8020/3未分化癌，Nos

8020/3去分化癌

Essential and desirable diagnostic criteria  

Essential: undifferentiated: a malignant epithelial tumour of monotonous and discohesive cells, with exclusion of mimics; dedifferentiated: a biphasic neoplasm with a differentiated endometrioid component, usually gland-forming, and an undifferentiated component.  

Desirable: loss of expression of mismatch repair proteins (and/ or inactivating mutations) and/or SWI/SNF chromatin remodelling complex proteins is very characteristic but is neither specific nor sensitive for diagnosis.

必需的和理想的诊断标准

必需：未分化癌:是一种由形态单一的、失黏附细胞组成的、排除其它相似疾病的恶性上皮性肿瘤；去分化癌:是一种双相肿瘤，具有分化性子宫内膜样（通常有腺体形成）成分和未分化的成分。

理想：错配修复蛋白(和/或失活突变)和/或SWI/SNF染色体重塑复合蛋白的表达缺失是非常有特征性的，但对诊断既不特异也不敏感。

Fig.1.66 Ovarian undifferentiated carcinoma. The carcinoma consists of sheets of discohesive cells that are small to intermediate in size, with uniform nuclei. This example displays scant cytoplasm.  

图1.66卵巢未分化癌。癌由小到中等大小的片状失粘附细胞组成，细胞核形态一致。本例显示胞质稀少。

Fig. 1.67 Ovarian dedifferentiated carcinoma. A Large portions of this tumour are undifferentiated: they display sheet-like growth of monotonousround cells.  The differentiated component is FlGO grade 1 endometrioid adenocarcinoma. Together, these findings are referred to as "dedifferentiated carcinoma". B SMARCA4 (BRG) loss in the undifferentiated comnonent.  

图1.67卵巢去分化癌。肿瘤的大部分是未分化的:它们表现为单一圆形细胞的片状生长。分化性成分为FlGO 1级子宫内膜样腺癌。总之，这些发现被称为“去分化癌”。B SMARCA4 (BRG)在未分化癌成分中失表达。

三、Carcinosarcoma of the ovary  

卵巢癌肉瘤  

Definition  

Carcinosarcoma is a biphasic malignant neoplasm composed of high-grade carcinomatous and sarcomatous elements.

定义

癌肉瘤是一种由高级别癌成分和肉瘤成分组成的双相性恶性肿瘤。

ICD-O coding  

8980/3 Carcinosarcoma Nos

ICD-O编码

8980/3 癌肉瘤NOS

Essential and desirable diagnostic criteria  

Essential: a biphasic pattern with high-grade carcinomatous and sarcomatous elements.

必需和理想的诊断标准

必需:高级别癌成分和肉瘤成分的双相性模式。

Fig.1.68 Ovarian carcinosarcoma. Gross appearance. A solid,necrotic tumour involving the ovary.  

图1.68卵巢癌肉瘤。大体表现。一个切面呈实性、坏死性、累及卵巢的肿瘤。

Fig. 1.6 Ovarian carcinosarcoma. A This tumour shows a biphasic pattern, with high-grade epithelial and mesenchymal elements. B Another example showing a malignant chondroid component as a heterologous element.  

图1.6卵巢癌肉瘤。A此肿瘤表现为双相性模式，具有高级别的上皮成分和间叶成分。B另一例显示恶性软骨样成分作为异源性成分。

四、Mixed carcinoma of the ovary  

卵巢混合癌

Definition  

Mixed carcinoma of the ovary is an ovarian carcinoma composed of two or more different histological types.

定义

卵巢混合癌是一种由两种或两种以上不同组织学类型组成的卵巢癌。

ICD-O coding  

8323/3 Mixed cell adenocarcinoma

ICD-O编码

8323/3混合细胞腺癌

Essential and desirable diagnostic criteria  

Essential: the presence of two (or more) ovarian carcinoma hitological types, with the components showing distinct are unequivocal differences by histomorphology.  

Desirable: differences between the two components based on ancillary testing.  

必需和理想的诊断标准

必需:存在两种(或两种以上)卵巢癌组织学类型，在组织形态学上显示明显的差异。

理想:辅助检查显示两种成分之间的差异。

Fig.1.70 Mixed ovarian carcinoma, clear cell carcinoma component. Tubulocysticpattern lined by cuboidalcells with cytoplasmic clearing.  

Fig.1.70卵巢混合癌，透明细胞癌成分。管囊状结构，衬覆立方细胞，胞质透明。

Fig. 1.71 Mixed ovarian carcinoma, endometrioid component. Tubular glands lined by endometrioid-type epithelium.  

图1.71卵巢混合癌，子宫内膜样癌成分。管状腺体衬覆子宫内膜型上皮。

间叶肿瘤  

一、Endometrioid stromal sarcoma of the ovary  

卵巢子宫内膜样间质肉瘤  

Definition  

Endometrioid stromal sarcoma is a low-grade mesenchymal neoplasm with a morphology resembling that of proliferativetvpe endometrial stroma.

定义

子宫内膜样间质肉瘤是一种低级别间叶源性肿瘤，其形态与增殖期子宫内膜间质相似。

ICD-O coding  

8931/3 Endometrioid stromal sarcoma, low grade  

8930/3 Endometrioid stromal sarcoma, high grade

ICD-O编码

8931/3子宫内膜样间质肉瘤，低级别

8930/3子宫内膜样间质肉瘤，高级别

Essential and desirable diagnostic criteria  

Essential: diffusegrowth of uniform small cells, sometimes with whorling around arteriole-like vessels, resembling proliferativetype endometrial stroma; exclusion of a uterine tumour.  

Desirable: presence of endometriosis.

必需和理想的诊断标准

必需:均匀一致的小细胞弥漫性生长，有时环绕小动脉样血管，类似增殖期样子宫内膜间质;排除子宫肿瘤。

理想:存在子宫内膜异位症。

Fig.1.72 Low-grade endometrioid stromal sarcoma arising from endometriosis. Tumour cells grow in sheets; they are small and uniform, with bland cytological features. The tumour is juxtaposed to endometriosis.  

图1.72子宫内膜异位症引起的低级别子宫内膜样间质肉瘤。肿瘤细胞呈片状生长;它们小而一致，细胞学特征温和。肿瘤与子宫内膜异位症并存。

二、Smooth muscle tumours of the ovary  

卵巢平滑肌肿瘤  

Definition  

Smooth muscle tumours of the ovary include benign, low-malignant-potential, and malignant mesenchymal tumours showing smooth muscle differentiation.

定义

卵巢平滑肌肿瘤包括良性、低度恶性潜能、恶性间叶源性肿瘤，显示平滑肌方向分化。

ICD-O coding  

8890/0 Leiomyoma NOS  

8890/3 Leiomyosarcoma Nos  

8897/1 Smooth muscle tumour of uncertain malignant potential

ICD-O编码

8890/0平滑肌瘤NOS

8890/3平滑肌肉瘤Nos

8897/1恶性潜能未定的平滑肌肿瘤

Essential and desirable diagnostic criteria  

Essential: fascicular growth; bland cytology, low mitotic count, and absence of tumour cell necrosis (leiomyoma); cytological atypia with or without brisk mitoses and with or without tumour cell necrosis (spindle leiomyosarcoma).

必需和理想的诊断标准

必需:成束状生长;细胞形态温和，核分裂计数少，缺乏肿瘤性坏死(平滑肌瘤);细胞有异型性伴或不伴核分裂，伴或不伴肿瘤性坏死(梭形平滑肌肉瘤)。

Fig.1.73 Cellular leiomyoma. The tumour is wellcircumscribed from adjacent ovarian parenchyma. It is cellular, with uniform elongated and bland tumour cells forming intersecting fascicles.  

图1.73富细胞性平滑肌瘤。肿瘤与邻近的卵巢实质界限清楚。它是富细胞性的，由均匀一致的拉长而温和的肿瘤细胞组成，交叉呈束状排列。

三、Ovarian myxoma  

卵巢黏液瘤

Definition

Oyarian myxoma is a benign tumour with abundant myxoid matrix, resembling its soft tissue counterpart.

定义

卵巢黏液瘤是一种良性肿瘤，有丰富的黏液样基质，类似于软组织对应肿瘤。

ICD-O coding  

88400 Myxoma NOS

ICD-O编码

88400 黏液瘤NOS

Essential and desirable diagnostic criteria

Essential: paucicellular tumour with striking and extensive myxoid matrix; oval to spindle cells with bland cytological features abundant capillaries with or withoutplexiformarrangement.

必需和理想的诊断标准

必需:肿瘤有显著、广泛的黏液样基质;卵圆形或梭形细胞，细胞形态温和，毛细血管丰富，伴或不伴丛状排列方式。

Fig.1.74 Ovarian myxoma. The tumour is paucicellular, with spindle to stellate cells displaying small and bland nuclei. Cells are embedded in an abundant myxoid backround. Small capillary vessels are seen at the bottom left.

图1.74卵巢黏液瘤。肿瘤细胞少，梭形至星芒状，核小而温和。细胞嵌入丰富的黏液背景中。左下方可见小毛细血管。

四、Other ovarian mesenchymal tumours  

其他卵巢间叶源性肿瘤

Other benign and malignant mesenchymaltumours that may occur in the ovary include high-grade endometrial stromal sarcoma, Ewing sarcoma,rhabdomyosarcoma (may be part of DICER1 syndrome) , benign and malignant vascular tumours,lipomatous tumours,nerve sheath tumours (including those associated with neurofibromatosis), solitary fibroustumour, perivascular epithelioid cell tumour (PEComa) / lymphangiomyomatosis, inflammatorymyofibroblastictumour,low-grade fibromyxoid sarcoma, and secondary involvement by gastrointestinal stromal tumour. Some of these tumours may arise in association with another ovarian tumour, more commonly a maturecystic teratoma.Before establishing a diagnosis of certain primary ovarian sarcomas, it is important to rule out metastases, as well as sarcomatous overgrowth in a mesodermal adenosarcoma or a carcinosarcoma .

其他可能发生在卵巢的良性和恶性间叶源性肿瘤包括高级别子宫内膜间质肉瘤，尤文氏肉瘤，横纹肌肉瘤(可能是DICER1综合征的一部分)，良性和恶性血管源性肿瘤，脂肪源性瘤肿瘤，神经鞘肿瘤(包括与神经纤维瘤病相关的肿瘤)，孤立性纤维瘤，血管周上皮样细胞肿瘤(PEComa) /淋巴管肌瘤病，炎性肌成纤维细胞瘤，低级别纤维黏液样肉瘤，以及胃肠道间质瘤继发累及。其中一些肿瘤可能与卵巢其他肿瘤相关，更常见的是成熟性囊性畸胎瘤。在确定某些原发性卵巢肉瘤的诊断之前，重要的是排除转移，以及中胚层腺肉瘤或癌肉瘤的肉瘤样成分过度生长。

混合性上皮和间叶肿瘤

Adenosarcoma of the ovary  

卵巢腺肉瘤

Definition

Adenosarcoma is a biphasic neoplasm with benign to atypical epithelial and low-grade malignant stromal components.

定义

腺肉瘤是一种双相性肿瘤，由良性至非典型上皮和低级别恶性间质成分组成。

ICD-O coding  

933/3 Adenosarcoma

ICD-O编码

933/3腺肉瘤

Essential and desirable diagnostic criteria

Essential: biphasictumour composed of benign or atypical Müllerian epithelium and a malignant (typically low-grade) stromal component.

必需和理想的诊断标准

必需:由良性或非典型苗勒上皮和恶性(通常为低级别)间质成分组成的双相性肿瘤。

Fig. 1.75 Adenosarcoma. AAt lower magnification, the tumour shows a striking phyllodes-like configuration. B The tumour shows polypoid projections of cellular stroma into a large cystic space lined by endometrioid-type epithelium associated with squamous metaplasia.

图1.75腺肉瘤。A 低倍镜下，肿瘤呈显著的分叶状结构。B肿瘤显示由富细胞性间质形成的息肉样突起深入囊腔内，囊腔衬覆伴有鳞状化生的子宫内膜样上皮。

整理：南瓜子儿

审核：樊月

设计：鹏飞

编辑：雅芸

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