Vulvar malignant granular cell tumor
Introduction
Introduction to vulvar malignant granulosa cell tumor Vulvar malignant granulosa cell tumor according to its tissue origin, some scholars believe that it should be called malignant granulosa cell Schwann cell tumor, but the habit is still called malignant granulosa cell tumor. basic knowledge The proportion of illness: 0.0016% Susceptible people: no special people Mode of infection: non-infectious Complications: lung metastases
Cause
The etiology of vulvar malignant granulosa cell tumor
Disease factors (95%):
It has been thought in the past that malignant granulosa cell tumors are derived from myoblasts (called malignant granular myoblasts), histiocytes, fibroblasts, undifferentiated mesenchymal cells, etc., but in recent years they have been supported by immunohistochemistry and electron microscopy. It is the source of Schwann cells.
Pathogenesis
The surface of the tumor is intact and the boundary of the tumor is unclear. Therefore, the tumor often carries surrounding fat and muscle, and the tumor of the cut surface is grayish yellow.
Under the light microscope, the tumor cells are different in size, nested or cord-like, round, polygonal, oval, fusiform, rich in cytoplasm, filled with eosinophilic particles of similar size and uneven distribution, PAS positive The size of the nucleus is unequal and deep stained. The mitotic image is >2/10HPF. Coagulative necrosis can be seen. The diagnosis is more clear when the metastasis is seen. Under the electron microscope, the cytoplasmic granules are autophagic vesicles, and the medulla or no Axon-like structure of the medulla.
The tumor cells were positive for S-100 protein and neuron-specific enolase (NSE), and CD68 and CD57 (Leu-7) were positive, but the specificity was not strong.
Prevention
Prevention of vulvar malignant granulosa cell tumor
Do a good job of prevention according to the tertiary prevention of cancer.
Complication
Vulvar granulosa cell tumor complications Complications
It can be transferred to the lungs, liver and bone through lymph nodes.
Symptom
Vulvar malignant granulosa cell tumor symptoms Common symptoms Cystic mass multiple nodules mitosis
Clinically, there are no special symptoms, most of which are occasionally found, more common in the labia, occasionally in the clitoris, more than a single hair, multiple nodules are rare, usually expressed as dermis or subcutaneous isolated painless nodules, ranging in size from 1.5 to 12 cm Hard quality.
Examine
Examination of vulvar malignant granulosa cell tumor
Tumor marker examination, p53 tumor suppressor gene detection, immunohistochemistry.
Histopathological examination.
Diagnosis
Diagnosis and differentiation of vulvar malignant granulosa cell tumor
diagnosis
Because the dysplasia and cellular pleomorphism of malignant granulosa cell tumor nucleus may not be obvious, clinical benign granulosa cell tumors may show increased nuclear polymorphism and mitotic figures, while benign granulosa cell tumors may be multi-center lesions, so good, Malignant is difficult to identify, especially paying special attention to the histological manifestations of malignant granulosa cell tumors, and biological behavior is a malignant side. It is often difficult to make a diagnosis before metastasis, so more samples should be taken during diagnosis. Careful search for nuclear heterotypic areas, paying special attention to vascular invasion. Some scholars have suggested that the diagnostic criteria for malignant granulosa cell tumors should be combined with histomorphology and immunohistochemical staining. It is considered to have: increased mitotic figures; mass necrosis; vacuolated nucleus with large Nucleolus; significant fusiform; Ki-67>10% and p53-positive, Tsuchida et al. (1997) suggest that heterotypic mitotic figures are the most predictive of invasive clinical behavior, while nuclear atypia and local infiltration cannot be used as diagnostic malignancy. Standard.
Differential diagnosis
Vulvar leiomyomas
The tumor is hard and has a clear boundary, and the pathological examination can confirm the diagnosis.
2. Vulvar fibroma
The tumor has an envelope with clear boundaries, often with pedicles, and a large number of fibroblasts under the microscope.
3. Vulvar malignant tumor
Such as vulvar leiomyosarcoma, vulvar fibrosarcoma, etc., malignant tumors grow faster, often accompanied by pain, pathological examination can confirm the diagnosis.
