【衡道丨干货】WHO图注英文学习手帐 (性索间质肿瘤--纯性索肿瘤)

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。上一期分享了卵巢性索间质肿瘤中的纯间质肿瘤，本期将带来性索间质肿瘤中的纯性索肿瘤。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、Adult granulosa cell tumour

成人型粒层细胞瘤

Definition

Adult granulosa cell tumour is a tumour composed of granulosa cells growing in a variety of patterns, admixed with a variable population of fibroblasts or theca cells.

定义

成人型粒层细胞瘤是一种由多种生长模式的颗粒细胞与不同数量的纤维母细胞或卵泡膜细胞混合而成的肿瘤。

ICD-O coding

8620/3 Adult granulosa cell tumour of ovary

ICD-O编码

8620/3卵巢成人型粒层细胞瘤

Essential and desirable diagnostic criteria

Essential: granulosa cells with typical nuclear features, growing in a variety of patterns.

Desirable: reticulin surrounding groups of cells; immunohistochemical positivity for sex cord markers.

必需和理想的诊断标准

必需:具有典型核特征的颗粒细胞，以多种模式生长。

理想:细胞巢周围环绕网状纤维;免疫组化示性索标记物阳性。

Tumours are typically positive for FOXL2, calretinin, inhibin
(although staining may vary in distribution and intensity), and
SF1. ER,pancytokeratin,CD99,and WT1 are frequently positive,and tumours can be
positive for SMA,desmin,and CD10.PAX8,CK7.and EMA are typically negative.

肿瘤通常阳性表达FOXL2、calretinin、inhibin（尽管染色可能在分布和强度上有所变化）和SF1。ER、广谱CK、CD99和WT1往往也是阳性表达，并且SMA、desmin和CD10表达可能呈阳性。PAX8、CK7和EMA通常阴性。

Diagnostic molecular pathology

Demonstration of the characteristic FOXL2 point mutation maybe helpful in selected cases.

诊断分子病理学

在某些情况下，特征性FOXL2点突变可能会对诊断有所帮助。

Fig.1.86 Adult granulosa cell tumour. The tumour has a nodular appearance, with extensive areas of haemorrhage and
necrosis. The nodules have a yellow and soft cut surface.

图1.86成人型粒层细胞瘤。肿瘤呈结节状，有大面积出血和坏死。结节切面灰黄、质软

Fig. 1.87 Adult granulosa cell tumour. A Insular growth pattern. B Trabecular growth pattern. C Macrofollicular growth pattern. D Microfollicular growth pattern Call-Exner bodies composed of monotonous tumour cells with nuclear grooves and folds and scant cytoplasm disposed around spaces filled with hyalinized material.

图1.87 成人型粒层细胞瘤。A 岛状生长模式。B 小梁状生长模式。C大滤泡型生长模式。D微滤泡型生长模式，Call-Exner小体由单一的肿瘤细胞组成，细胞核有核沟、核膜皱缩，胞浆稀少，分布在充满透明样物质的间隙周围

Fig. 1.88 Adult granulosa cell tumour. 

A Fibroma-like growth. B Reticulin fibres surround groups of granulosa cells, unlike in fibroma, where reticulin fibres are present around individual cells.

图1.88成人型粒层细胞瘤。

A 纤维瘤样生长模式。B网状纤维围绕颗粒细胞巢，不同于纤维瘤网状纤维围绕单个细胞

二、Juvenile granulosa cell tumour

幼年型粒层细胞瘤

Definition

Juvenile granulosa cell tumour is a sex cord tumour composed of primitive-appearing granulosa cells growing in solid and follicular patterns.

定义

幼年型粒层细胞瘤是一种性索肿瘤，由实体状和滤泡状生长的原始颗粒细胞组成。

ICD-O coding

8622/1 Granulosa cell tumour, juvenile

8622/1粒层细胞瘤，幼年期

Essential and desirable diagnostic criteria

Essential: primitive granulosa cells with diffuse or nodular growth punctuated by irregularly shaped follicles.

Desirable:positive staining for sex cord markers.

必需和理想的诊断标准

必需:原始颗粒细胞呈弥漫性或结节性生长，内含不规则形状的滤泡。

理想:性索标记染色阳性。

Tumours usually express SF1,inhibin,calretinin,WT1,CD99,and CD56,and some express FOXL2(but lack associated mutation) and EMA.

肿瘤通常表达SF1、inhibin、calretinin、WT1、CD99和CD56，而一些表达FOXL2（但缺乏相关突变）和EMA。

Fig. 1.89 Juvenile granulosa cell tumour. The tumour has a predominantly nodular, solid, yellow cut surface with focal cystic and haemorrhagic areas.

图1.89幼年型粒层细胞瘤。肿瘤有明显的结节，切面实性、黄色，局灶见囊性区和出血区

Fig. 1.90 Juvenile granulosa cell tumour. There is a vague nodular growth with irregular
follicles showing basophilic secretion. The tumour cells have abundant eosinophilic cytoplasm. Inset: Prominent mitoses and apoptoses.

图1.90幼年型粒层细胞瘤。可见模糊的结节样生长，伴不规则滤泡，可见嗜碱性分泌物。肿瘤细胞有丰富的嗜酸性胞质。插图:明显的核分裂和细胞凋亡

三、Sertoli cell tumour 

支持细胞瘤

Definition

Sertoli cell tumour is a sex cord neoplasm composed of Sertoli cells arranged in a variety of patterns but most commonly as hollow or solid tubules.

定义

支持细胞瘤是一种由支持细胞形成多种结构组成的性索肿瘤，但最常见的是中空或实性小管状结构。

ICD-O coding

8640/1 Sertoli cell tumour Nos

ICD-O编码

8640/1支持细胞瘤

Essential and desirable diagnostic criteria

Essential: sertoliform tubules with or without other patterns displaying low-cuboidal cells with bland round nuclei. 

Desirable: positivity for sex cord markers. 

必需和理想的诊断标准

必需:支持细胞状小管伴或不伴其他形态，衬覆低立方细胞，核淡染圆形。

理想:可取性索标记阳性。

Fig. 1.91 Sertoli cell tumour. A The tumour shows small, round to elongated tubules lined by cuboidal cells with scant eosinophilic cytoplasm separated by minimal collagenous stroma. 

B Tubules and cords contain tumour cells with pale cytoplasm. The small to medium-sized nuclei are round to oval and bland

图1.91支持细胞瘤。A肿瘤显示小、圆或拉长的小管，衬覆立方细胞，有较少的嗜酸性细胞质，被少量的胶原间质分隔

B肿瘤细胞呈管状、条索状排列，胞浆淡染。细胞核呈小到中等大小、圆形到椭圆形

Fig. 1.92 Sertoli cell tumour, lipid-rich. The tumour is composed of tightly packed tubules with abundant pale (lipid-rich) cytoplasm and basally located small and round nuclei with bland cytological features

图1.92支持细胞瘤，富含脂质。肿瘤由紧密排列的小管组成，具有丰富的淡染(富含脂质)细胞质和位于基底部的小而圆的细胞核，细胞形态较为温和

四、Sex cord tumour with annular tubules 

伴有环状小管的性索肿瘤

Definition

Sex cord tumour with annular tubules is a sex cord tumour with sharply circumscribed nests composed of ring-like tubules that encircle basement membrane- like material.

定义

伴有环状小管的性索肿瘤是一种性索肿瘤，由环绕基底膜样物质的环状小管组成的界限分明的细胞巢组成。

ICD-O coding

8623/1 Sex cord tumour with annular tubules

ICD-O编码

8623/1伴有环状小管的性索肿瘤

Essential and desirable diagnostic criteria

Essential: characteristic tubular pattern with antipodal distribution of nuclei and basement membrane-like material.

必需和理想的诊断标准

必需:特征性的管状结构，细胞核和基底膜样物质反极向排列。

Fig. 1.93 Sex cord tumour with annular tubules. Discrete small nests with a conspicuous lubuar pattern and typical basement membrane-like material in a patient with Peutz-Jeghers syndrome

图1.93伴有环状小管的性索肿瘤。Peutz - Jegers综合征患者病例中，有明显的管状结构和典型的基底膜样物质分隔的小巢

Fig. 1.94 Sex cord tumour with annular tubules. Large nests with central cystic change, showing characteristic tubules at the periphery, most of which encircle hyaline material (not associated with Peutz-Jeghers syndrome).

图1.94伴有环状小管的性索肿瘤。中心囊性变的大巢，周围可见特征性的小管，大多数小管环绕透明样物质(与Peutz-Jeghers综合征无关)