衡道病理特邀撰稿作者翻譯了WHO部分圖?的圖注，并用手帳的?式進行中英?對照，且通過不同顏色的劃線將晦澀難懂的英文單詞與中?翻譯同時標(biāo)注，希望對專業(yè)英文的學(xué)習(xí)有所幫助。由于本篇目的以英文學(xué)習(xí)為主，篇幅有限，故未對各個疾病進行詳細(xì)闡述。全部圖片均來自WHO，若有不恰當(dāng)之處，還請評論區(qū)指正。
Definition
Serous cystadenoma, adenofibroma, and surface papilloma are benign serous tumours composed of cells resembling fallopian tube epithelium.
定義
漿液性囊腺瘤、腺纖維瘤和表?乳頭狀瘤是由類似輸卵管上?細(xì)胞組成的良性漿液性腫瘤
Essential and desirable diagnostic criteria
Essential: tumour with benign serous epithelium, with or without fibromatous stroma; for cystadenoma, the cysts should be >1 cm
基本的診斷標(biāo)準(zhǔn)
基本特征：良性漿液上皮腫瘤，伴或不伴纖維瘤間質(zhì)；囊腺瘤，囊腫大小應(yīng)為>1cm。
Fig. 1.04 A Ovarian serous cystadenofibroma.
The tumour is predominantly cystic and the cyst lining is mostly smooth, with some nodular areas.
B Serous cystadenofibroma.
Glands lined by bland tubal-type epithelium, with occasional ciliated cells, are present in a fibromatous stroma.
圖1.04 A卵巢漿液性囊腺纖維瘤。腫瘤主要是囊性的，囊壁?部分平滑，有?些結(jié)節(jié)狀區(qū)域。
B漿液性囊腺纖維瘤。在纖維間質(zhì)中，有內(nèi)襯溫和的輸卵管型上?的腺體，偶有纖?細(xì)胞。
Fig. 1.05 Serous surface papilloma. Stromal papillae covered by bland tubal-type epithelium project from the ovarian surface.
圖1.05漿液性表?乳頭狀瘤。被覆輸卵管型上皮的乳頭，從卵巢表面突出。
卵巢漿液性交界性腫瘤
Definition
Serous borderline tumour (SBT) is a non-invasive, low-grade, proliferative serous epithelial neoplasm.
定義
漿液性交界性腫瘤(SBT)是?種非浸潤性、低級別、增生性漿液性上皮腫瘤。
Essential and desirable diagnostic criteria SBT
Essential: epithelial proliferation (with papillary hierarchical branching or micropapillary/cribriform pattern, low-grade cytology) with no stromal invasion. SBT with microinvasion Essential: stromal microinvasion < 5 mm in greatest dimension in any single focus with small cell clusters / individual cells with abundant dense eosinophilic cytoplasm or small papillae within clear lacunar spaces, cytologically similar to the noninvasive component of SBT.
基本的診斷標(biāo)準(zhǔn)
SBT
基本特征:上皮細(xì)胞增生(伴有多級乳頭狀分或微乳頭狀/篩狀模式，低級 別細(xì)胞學(xué)特征)，無間質(zhì)浸潤。SBT伴微浸潤 基本特征:在任何單個病灶中，間質(zhì)微浸潤最?徑< 5 mm，微浸潤灶為間 質(zhì)內(nèi)強嗜酸性細(xì)胞質(zhì)的?細(xì)胞簇/單個細(xì)胞，或收縮間隙內(nèi)小乳頭。細(xì)胞學(xué)上類似于SBT的?浸潤性成分。
Fig. 1.06 Serous borderline tumour.
A Papillae are architecturally complex, with hierarchical branching.
B Papillae are lined by stratifified epithelium with detached small clusters of tumour cells.
圖1.06交界性漿液性腫瘤。
A 乳頭在結(jié)構(gòu)上是復(fù)雜的，具有多級分支。
B 乳頭由復(fù)層上?和脫落的小簇腫瘤細(xì)胞構(gòu)成。
Fig. 1.07 Micropapillary serous borderline tumouir.
A Micropapillary architecture is prominent.
B Elongated micropapillae directly emanate from a large papilla, producing the so-called Medusa head appearance.
圖1.07微乳頭狀漿液性交界性腫瘤。
A 明顯的微乳頭狀結(jié)構(gòu)。
B 細(xì)?的微乳頭直接從?個?乳頭發(fā)出，產(chǎn)?所謂的美杜莎頭外觀。
Fig. 1.08 Epithelial-type non-invasive implants associated with ovarian serous borderline tumour.
A Complex papillary architecture is present within an epithelium-lined space.
B Papillae contain cells with low-grade nuclear features. Psammoma bodies are present.
圖1.08與卵巢漿液性交界性腫瘤相關(guān)的上皮性?浸潤性種植。
A 在上?內(nèi)襯的間隙內(nèi)有復(fù)雜的乳頭狀結(jié)構(gòu)。
B 乳頭含有低級別核特征的細(xì)胞。有砂礫體。
Fig. 1.09 Desmoplastic non-invasive implants associated with ovarian serous borderline tumour.
A .Low-grade simple glands with slight epithelial stratifification are present within abundant desmoplastic stroma.
B .Individual epithelial cells (arrows) are present within abundant desmoplastic stroma. This fifinding does not fulfifil the criteria for invasive implants.
圖1.09 與卵巢漿液性交界性腫瘤相關(guān)的促結(jié)締組織增?性?浸潤性種植。
A .在豐富的結(jié)締組織間質(zhì)中存在低 級別簡單腺體伴輕度復(fù)層上?。
B .單個上?細(xì)胞(箭頭)位于豐富的 促結(jié)締組織間質(zhì)中。這?發(fā)現(xiàn)不符合浸潤性種植的標(biāo)準(zhǔn)。
Fig.1.10 Invasive implants associated with ovarian serous borderline tumour.
AThere is destructive infifiltration of underlying tissue. Small papillae and micropapillae are markedly crowded and haphazardly arranged. The histological appearance is akin to that of invasive low-grade serous carcinoma.
BSmall papillae and micropapillae are present within clear lacunar spaces and demonstrate low-grade atypia. Psammoma bodies are also seen.
圖1.10卵巢漿液性交界性腫瘤相關(guān)的浸潤性種植。
A組織有破壞性浸潤。?乳頭和微乳頭明顯擁擠和無序排列。組織學(xué)外觀類似于浸潤性低級別漿液性癌。
B收縮的裂隙內(nèi)可見小乳頭和微乳頭，表現(xiàn)為輕度不典型性。也可以看到砂礫體。
Fig. 1.11 Microinvasion in a serous borderline tumour.
Small nests and individual tumour cells with abundant eosinophilic cytoplasm (arrows) are present within spaces devoid of epithelial lining in the stroma. This is the most common pattern of microinvasion.
圖1.11漿液性交界性腫瘤伴微浸潤。
可見小巢狀腫瘤細(xì)胞和富含嗜酸性細(xì)胞質(zhì)的單個腫瘤細(xì)胞(箭頭)，周圍存 在收縮間隙。這是最常見的微浸潤模式。
Fig. 1.12 Microinvasive low-grade serous carcinoma.
Crowded small and medium-sized papillae in clear lacunar spaces (< 5 mm in greatest extent) are similar to the morphology of an invasive low-grade serous carcinoma.
圖1.12微浸潤性低級別漿液性癌。收縮腔隙內(nèi)密集的中小型乳頭突起(最?直徑< 5mm)，與浸潤性低級別漿液性癌的形態(tài)相似。
Fig. 1.13 Serous borderline tumour in a pelvic lymph node. Papillary proliferation of bland serous epithelium and psammoma bodies, at the left. There is also endosalpingiosis involving this node, at the right.
圖1.13盆腔淋巴結(jié)中的漿液性交界性腫瘤。左側(cè)為淡染的漿液性上皮呈乳頭狀增生和沙礫體。右側(cè)也可?累及此淋巴結(jié)的輸卵管上?異位。
Fig. 1.14 Endosalpingiosis. Epithelial stratifification, cell tufting/detachment, and papillary architecture of epithelial-type non-invasive implants are absent. Endosalpingiosis does not qualify as advanced-stage in the setting of an ovarian serous borderline tumour.
圖1.14 輸卵管內(nèi)膜異位癥。缺乏上?細(xì)胞復(fù)層、成簇/脫落和乳頭狀結(jié)構(gòu)的非浸潤性種植。在卵巢漿液性交界性腫瘤的背景下，輸卵管內(nèi)膜異位癥不符合晚期標(biāo)準(zhǔn)。
Fig. 1.15 A Low-grade serous neoplasm.
A Papillary structures with relatively uniform small cells and low-grade nuclear atypia.
B Serous borderline tumour. Peritoneal flfluid cytology. Note papillae with mild epithelial atypia encompassing a psammoma body.
C Serous borderline tumour. Peritoneal flfluid cytology. Note the 3D epithelial clusters with mild epithelial atypia and discernible nucleoli.
圖1.15低級別漿液性腫瘤。
A乳頭狀結(jié)構(gòu)，相對均勻的小細(xì)胞和低 級別核異型性。
B漿液性交界性腫瘤。腹水細(xì)胞學(xué)。可見乳頭狀結(jié)構(gòu)，襯覆輕度異型上皮，包圍砂礫體。C漿液性交界性腫瘤。腹水細(xì)胞學(xué)?？梢?D上?簇，上?呈輕度異型，可見核仁。
卵巢低級別漿液性癌
Definition
Low-grade serous carcinoma (LGSC) is an invasive serous neoplasm with low-grade malignant features.
定義
低級別漿液性癌是?種具有低級別惡性特征的浸潤性漿液性腫瘤。
Essential and desirable diagnostic criteria
Essential: invasive serous tumour with small nests, glands, papillae or micropapillae, and inverted macropapillae, frequently free-floating within unlined clear spaces; low-grade cytological atypia (< 3-fold variation in nuclear size); low mitotic activity.
基本的診斷標(biāo)準(zhǔn)
基本特征:浸潤性漿液性腫瘤，有小巢、腺樣、乳頭或微乳頭和倒置大乳頭，常在無襯覆上皮的收縮間隙內(nèi)自由漂浮;低級別細(xì)胞異型性(核大小< 3倍);低核分裂計數(shù)。
Fig. 1.16 Low-grade serous carcinoma. A large multicystic mass with nodular areas and excrescences.
圖1.16低級別漿液性癌。大的多囊腫塊，有結(jié)節(jié)狀區(qū)域和贅生物。
Fig.1.17 Low-grade serous carcinoma. Small papillae containing cells with uniform nuclei and inconspicuous mitotic activity.
圖1.17低級別漿液性癌。小乳頭含有均勻?致的細(xì)胞核和不明顯的核分裂象。
Fig. 1.18 Low-grade serous carcinoma. This example exhibits an inverted macropapillary pattern of invasion. The macropapillae are surrounded by unlined clear spaces.
Scattered small papillae, clusters, and individual cells are also present.
圖1.18低級別漿液性癌。圖示倒置大乳頭狀浸潤模式。大乳頭被無上皮襯覆的收縮間隙包圍。也可見散在的小乳頭、簇狀和單個細(xì)胞。
Fig.1.19 Low-grade serous carcinoma.
This peritoneal washing specimen shows numerous papillary clusters of uniform cells, as well as psammoma bodies. Note that the fifindings in this specimen are not diagnostic of low-grade serous carcinoma and could also be seen in association with a serous borderline tumour .
圖1.19低級別漿液性癌。腹膜沖洗標(biāo)本可見大量均勻的乳頭狀細(xì)胞簇，以及砂礫體。需要注意的是，本標(biāo)本中的發(fā)現(xiàn)不能診斷低級別漿液性癌，也可見于漿液性交界性腫瘤。
卵巢?級別漿液性癌
Definition
High-grade serous carcinoma (HGSC) is a high-grade epithelial neoplasm demonstrating serous differentiation.
定義
高級別漿液性癌(HGSC)是?種顯示漿液性分化的高級別上皮腫瘤。
Essential and desirable diagnostic criteria
Essential: serous tumour with solid (with slit-likespaces), papillary, glandular, or cribriform ar chitecture; large, markedly atypical nuclei (nuclear size variability of > 3-fold); high mitotic activity. Desirable (in selected cases): WT1 immunoreactivity; mutationtype p53 expression.
基本的診斷標(biāo)準(zhǔn)
基本特征:漿液性腫瘤，呈實性(伴裂隙樣間隙)、乳頭狀、腺狀或篩狀結(jié) 構(gòu);??明顯的異型性核(核?? >正常核3倍);高核分裂計數(shù)。輔助診斷(免疫組化)：WT1陽性；p53呈突變型表達。
Fig. 1.20 High-grade serous carcinoma. Papillary structures containing cells with markedly pleomorphic nuclei and conspicuous mitotic activity.
圖1.20?級別漿液性癌。具有 明顯多形性核和較多核分裂的細(xì)胞構(gòu)成乳頭狀結(jié)構(gòu)。
Fig.1.21 High-grade serous carcinoma.
A Papillary architecture.
B Solid architecture with tumour-infifiltrating lymphocytes.
C Prominent clear cell change, mimicking clear cell carcinoma. This fifinding is often focal, and the clear cell areas show the same immunophenotype as conventional high-grade serous carcinoma.
D Intracytoplasmic mucin in some tumour cells .
圖1.21?級別漿液性癌。
A乳頭狀結(jié)構(gòu)。
B腫瘤浸潤淋巴細(xì)胞的實性結(jié)構(gòu)。
C透明細(xì)胞改變明顯，類似透明細(xì)胞癌。這?發(fā)現(xiàn)通常是局灶的，透明細(xì)胞區(qū)域顯示與經(jīng)典型高級別漿液性癌相同的免疫表型。
D部分腫瘤細(xì)胞胞漿內(nèi)黏蛋白(黏蛋白染?陽性)。
Fig. 1.22 High-grade serous carcinoma (HGSC).
A SET (solid, endometrial-like, transitional) pattern of HGSC with glandular (pseudoendometrioid) architecture.
B SET pattern of HGSC with transitional cell-like architecture.
C Diffffuse WT1 expression in an HGSC with solid and pseudoendometrioid (cribriform) architecture.
圖1.22?級別漿液癌(HGSC)。
A SET(實性，子宮內(nèi)膜樣，移行細(xì)胞樣)型HGSC伴腺樣(假子宮內(nèi)膜樣)結(jié) 構(gòu)。
B 具有移?細(xì)胞樣結(jié)構(gòu)的HGSC SET模式。
C WT1在實性和假?宮內(nèi)膜樣(篩狀)結(jié)構(gòu)的HGSC中彌漫表達。
Fig. 1.23 High-grade serous carcinoma.
A Mutant-pattern p53 immunostaining with strong nuclear expression in almost all tumour cell nuclei (> 80%).
B Mutant-pattern p53 immunostaining with complete loss of expression in tumour cells. Note that the retained staining in benign cells serves as an internal control.
C Mutant-pattern p53 immunostaining with variable cytoplasmic staining. This is the least common staining pattern seen in highgrade serous carcinoma.
圖1.23?級別漿液性癌。
A突變型p53免疫染色，幾乎所有腫瘤細(xì)胞核彌漫強陽性(> 80%)。
B突變型p53免疫染色，在腫瘤細(xì)胞中完全失表達。注意，良性細(xì)胞中保留的染色作為內(nèi)對照。
C突變型p53免疫染色，不同程度的胞漿染色。這是高級別漿液性癌中最不常見的染色模式。
Fig.1.24 High-grade serous carcinoma. Pleomorphic tumour cells with large plasmic vacuoles and marked nuclear atypia .
圖1.24高級別漿液性癌。多形性腫瘤細(xì)胞具有?的胞漿內(nèi)空泡和明顯的核異型性。
整理：南瓜子兒
審核：樊月
設(shè)計：鵬飛
編輯：V
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