Pathological type of ovarian cancer 1. Epithelial ovarian cancer
The most common, accounting for 85% -90 ovarian cancer%, more common in older women, the peak age of 50-60 years old. And from the ovarian surface epithelial retraction from the surface to the duct and the ovarian cyst epithelium.
(1) serous carcinoma: including serous cystadenocarcinoma and papillary carcinoma. 50% of both ovaries simultaneously, easily disseminated abdominal pelvic cavity, may be associated with massive ascites, is the most common epithelial ovarian cancer . Cut surface is solid and cystic tumor, cystic fluid is serous cyst wall of papillae and often more brittle solid nodule, more than half visible exogenous nipple. Microscope these tumors can be differentiated according to well-differentiated cancer cells, differentiated and poorly differentiated cancer. Well-differentiated papillary carcinoma of the dense branches, showing that nuclear division, cells were severely anaplastic, with significant interstitial infiltration, sand body were more common. Medium and low degree of differentiation are more real, of areas, nipples or less disappeared, sand body is not easy to see.
(2) teach liquid carcinoma: a more rare serous carcinoma, the incidence of bilateral ovarian while 10% -20%. Most tumors were multilocular, solid or partially cystic, mucus gel capsule contains very few exogenous nipple, the real zone of creamy white or pale red, dense structure crisp. Microscope is also divided into three levels, well-differentiated and moderately differentiated adenoid structures were clearly visible, dense branching epithelial papillae, a total wall of the gland, the more obvious nuclear atypia, stromal infiltration. Poorly differentiated adenoid structures were not obvious, atypical mitotic figures increased very little mucus cells. Patients often died of intra-abdominal intestinal obstruction caused by metastasis.
(3) endometrioid carcinoma: rare in China. Tumors were solid, cut off-white, very crisp, there are large areas of cystic papillary those things, about 1 / 5 cases of endometrial cancer combined. The incidence of both ovaries 30%. Microscopic histology and endometrial adenocarcinoma similar. But the nipple short wide stroma more, less or lack of glands back to back characteristics.
(4) malignant Bo Lena (Brenner) tumor and transitional cell carcinoma: are the fiber cell carcinoma. Brenner tumors from the benign into malignant cancer, who said Brenner tumor. Two cases were less common in middle-aged women. As cystic or solid tumors. As a small number of cases, the prognosis remains to be discussed.
(5) clear cell carcinoma: from Yan Mullerian tubes, rare. Tumors were solid, lobulated, cut fish shape, may have cysts of varying sizes. Mostly unilateral. Microscopically, a Portland kind of tumor cells: clear cell, spike-like cells and eosinophils. Tumor cells were nests, papillary and tubular arrangement. Visible calcium deposition. Endometriosis is often associated with poor prognosis.
Pathological type of ovarian cancer 2. Ovarian metastatic tumor
As the rich lymphatic and blood supply of ovarian, making it a very easy to grow organs metastases. Number of primary breast cancer in the digestive tract and often transferred first to the ovaries, Kuken Bo (Krukenberg) said tumor or signet ring cell carcinoma is an important one. From the reproductive organs of ovarian metastases outside the ovary are generally kept the prototype, showing kidney-shaped or elliptical imprison-shaped, smooth, encapsulated, solid rubber-like section, mostly bilateral. Microscope, the organizational form of a variety, for the general adenocarcinoma, mucinous adenocarcinoma. The most characteristic is the signet ring cell carcinoma, showing connective tissue with varying amounts of venom cells, small round or irregular shape, cytoplasmic mucin content of the nuclei pressed against the side of a long time for a typical signet-ring cell . Metastatic ovarian cancer are generally younger, more common in premenopausal women, the prognosis is poor, five-year survival rate of 10%.
3. Stromal tumor of ovarian hormone
Including sources of sex cord stromal granulosa cells, theca cells, fibroblasts, stromal cells to support the swelling Cave. Many sex cord stromal tumors can secrete steroids, resulting in endocrine symptoms. To granulosa cell tumor and theca cell carcinoma of the common, often mixed these two tumors exist, may secrete estrogen. Solid tumors, mostly unilateral, gray, or Si-yellow cut surface. Microscopic granulosa cell tumor cells were round or angular, arranged in nests, follicle-like or diffuse into the film. Theca cells to be oval or spindle-shaped, arranged in interwoven bundles, cytoplasm rich in lipids. Granular cell carcinoma should be regarded as potentially malignant, and its high recurrence rate, but late recurrence is mainly spread in the abdominal cavity and rarely distant metastasis. Theca cell tumor of low malignant, mostly occurs in women over 50 years of age, both were good prognosis.
4. Malignant ovarian germ cell tumors
Occur in young people, accounting for 6% of ovarian cancer. Tumor from the original germ cells in the gonads, the higher the degree of malignancy and more easy to transfer, there are sensitive to this type of cancer chemotherapy, significantly improved its prognosis.
(1) embryonal carcinoma: high grade, often combined with other germ cell tumors, serum AFP and HCG can be positive. Drunk larger tumors, a capsule, hemorrhage and necrosis common. Microscopically, polygonal cells than the original composition of the solid pieces, of the cable and cell nests, shaped and clear, common nuclear fission, nuclear vacuolization, PAS-positive cells can be seen both inside and outside the glass-like bit by bit.
(2) Endodermal sinus tumor (yolk sac tumor): the highest grade, grow fast, transfer rate, serum AFP positive, RCG negative. Tumors were arranged in mesh and wire loop can be like, endodermal sinus samples (Schiller-team lval) bodies and gland structure, embryonal carcinoma element structure, PAS-positive cells can also be found inside and outside the drip.
(3) immature teratoma: inferior or similar to the incidence of endodermal sinus tumor. Unilateral large mass, solid and cystic cut surface, colorful form. The composition of the complex, most of undifferentiated embryonic tissue into neural epithelium, there are three germ layers of other organizations, such as gelatin, cartilage and so on. This high rate of tumor recurrence and metastasis, but the recurrence of tumors can be converted from the immature, regularity tend to resemble normal embryonic growth and development. Recurrence later, the tumor tissue to mature into the higher level, this development needs to mature some time to process.
Pathological type of ovarian cancer (4) dysgerminoma: Foreign data is the most common malignant ovarian germ cell tumors, internal reports and more rare than the immature teratoma. More than unilateral, side, 10% -20%. Solid, lobulated smooth surface, cut pink to brown. Microscopically, the tumor cells were round or polygonal, vesicular nuclear center, large eosinophilic nucleoli, cytoplasm rich in glycogen.