【衡道丨干货】WHO图注英文学习手帐 (生殖细胞肿瘤-胚胎性癌、非妊娠性绒毛膜癌及卵巢混合性生殖细胞肿瘤)

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。上一期分享了生殖细胞肿瘤中的无性细胞瘤与卵黄囊瘤，本期将带来生殖细胞肿瘤中的胚胎性癌、非妊娠性绒毛膜癌及卵巢混合性生殖细胞肿瘤。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、Embryonal carcinoma

胚胎性癌

Definition

Embryonal carcinoma is a primitive malignant germ cell tumour that may exhibit somatic or extraembryonal differentiation.

定义

胚胎性癌是一种原始的恶性生殖细胞肿瘤，可能表现为体细胞或胚胎外分化。

ICD-O coding

9070/3 Embryonal carcinoma NOS

ICD-O编码

9070/3 胚胎性癌NOS

Histopathology

Embryonal carcinoma is composed of monomorphic to pleomorphic cells growing in solid, nested, glandular, and papillary patterns, which are often admixed. The tumour cells are polygonal, contain abundant amphophilic or clear cytoplasm, and are mitotically active, with hyperchromatic and severely atypical nuclei. Syncytiotrophoblastic giant cells may be present，Ovarian embryonal carcinoma mostly presents admixed with other malignant germ cell components and is therefore classified as a mixed germ cell tumour.

组织病理学

胚胎性癌由单形到多形性细胞组成，呈实性、巢状、腺样和乳头状生长，这些形态常混合存在。肿瘤细胞呈多角形，含有丰富的嗜双色性或透明的细胞质，核分裂活跃，细胞核深染，有重度不典型性。可能存在合体滋养层细胞，卵巢胚胎性癌多表现为与其他恶性生殖细胞成分混合，因此被归类为混合性生殖细胞肿瘤。

Immunohistochemical

Immunohistochemically, embryonal carcinoma is positive for CD30, OCT4, SALL4, SOX2, and LIN28.

免疫组化

免疫组化结果显示，胚胎性癌CD30、OCT4、SALL4、SOX2和LIN28呈阳性。

Essential and desirable diagnostic criteria

Essential: high-grade primitive malignant germ cells arranged in glandular, papillary, and/or solid patterns.

Desirable: positivity for OCT4 and CD30 or SOX2 by immunohistochemistry.

必需和理想的诊断标准

必需:高级别原始恶性生殖细胞呈腺性、乳头状和/或实状排列。

理想:OCT4和CD30或SOX2免疫组化阳性。

Fig.1.113 Embryonal carcinoma. Embryonal carcinoma with glandular and papillary patterns.

图1.113胚胎性癌。呈腺性和乳头状排列。

Fig.1.114 Embryonal carcinoma. Embryonal carcinoma glandular pattern composed of pleomorphic tumour cells and syncytiotrophoblastic giant cells.

图1.114胚胎性癌。胚胎性癌腺样结构由多形性肿瘤细胞和合体滋养层细胞组成。

Fig.1.115 Embryonal carcinoma.

A CD30 stains embryonal carcinoma in a membranouspattern.

B SOX2 stains embryonal carcinoma in a nuclear pattern.

图1.115胚胎性癌。

A 胚胎性癌CD30染色呈膜阳性。

B 胚胎性癌SOX2染色呈核阳性。

二、Non-gestational choriocarcinoma

非妊娠性绒毛膜癌

Definition

Non-gestational choriocarcinoma is a malignant tumour composed of cytotrophoblast and syncytiotrophoblastthat is not of gestational origin.

定义

非妊娠性绒毛膜癌是一种非妊娠起源的由细胞滋养层细胞和合体滋养层细胞组成的恶性肿瘤。

ICD-O coding

9100/3 Choriocarcinoma NOS

ICD-O编码

9100/3 绒毛膜癌 NOS

Histopathology

The tumour consists of an admixture of mononuclear cytotrophoblast and multinucleated syncytiotrophoblast, often accompanied by extensive haemorrhage and necrosis, which may obscure the tumour cells. Some tumours are composed predominantly of mononuclear trophoblast. The tumour may be pure or may present as a component of a mixed germ cell tumour. In older women, foci of choriocarcinoma may be present within an ovarian epithelial carcinoma.

组织病理学

肿瘤由单核细胞滋养层细胞和多核合体滋养层细胞混合组成，常伴有大量出血和坏死，这可能掩盖肿瘤细胞。有些肿瘤主要由单核滋养层细胞组成。肿瘤可以是单一的，也可以是作为混合性生殖细胞肿瘤的组成部分。在老年妇女中，绒毛膜癌的病灶可能存在于卵巢上皮性癌中。

Immunohistochemical

Tumour cells are positive by hCG immunohistochemistry.

免疫组化

肿瘤细胞免疫组化hCG染色阳性。

Essential and desirable diagnostic criteria

Essential:biphasic tumour composed of mononuclear trophoblast and syncytiotrophoblast of non-gestational origin.

必须和理想的诊断标准

必须:由非妊娠起源的单核滋养细胞和合体滋养细胞组成的双相性肿瘤。

Fig.1.116 Non-gestational choriocarcinoma of ovary.

A Non-gestational choriocarcinoma of ovary consists of cytotrophoblast and syncytiotrophoblast.

B Non-gestational choriocarcinoma of ovary showing intimate admixture of syncytiotrophoblastic and cytotrophoblastic cells.

图1.116卵巢非妊娠性绒毛膜癌。

A 卵巢非妊娠性绒毛膜癌由细胞滋养层细胞和合体滋养层细胞组成。

B 卵巢非妊娠期绒毛膜癌，表现为合体滋养细胞和细胞滋养细胞的密切混合。

三、Mixed germ cell tumour of the ovary

卵巢混合性生殖细胞肿瘤

Definition

Mixed germ cell tumour is a tumour composed of two or more malignant germ cell components.

定义

混合性生殖细胞肿瘤是由两种或两种以上的恶性生殖细胞成分组成的肿瘤。

ICD-O coding

9085/3 Mixed germ cell tumour

ICD-O编码

9085/3 混合性生殖细胞肿瘤

Histopathology

Most tumours contain two or more malignant germ cell components; the rest contain three or more components. Specific quantitative criteria have not been established for the minimal amount of a second component for a case to qualify as a mixed germ cell tumour. However, immature teratomas containing a focus of yolk sac tumour or embryonal carcinoma measuring > 3 mm have been classified as mixed germ cell tumours. The most common combination is dysgerminoma and yolk sac tumour; other components may include embryonal carcinoma, choriocarcinoma, and immature teratoma.

组织病理学

大多数肿瘤含有两种或两种以上的恶性生殖细胞成分；或包含三种或更多成分。对于混合性生殖细胞肿瘤，较少的次要成分的数量尚未建立具体的定量标准。然而，未成熟畸胎瘤含有范围> 3mm的卵黄囊肿瘤或胚胎性癌的病灶，被归类为混合性生殖细胞肿瘤。最常见的组合是无性细胞瘤和卵黄囊瘤;其他成分可能包括胚胎性癌、绒毛膜癌和未成熟畸胎瘤。

Immunohistochemical

The morphological and immunohistochemical features of each individual component are identical to those of their counterparts in pure tumours. The components are often intimately admixed but may be present in separate areas of the mass.

免疫组化

每个单独成分的形态和免疫组织化学特征与它们对应的纯肿瘤相同。这些成分经常紧密混合，但也可能单独出现在不同区域。

Essential and desirable diagnostic criteria

Essential: two or more malignant germ cell components.

必须和理想的诊断标准

必须:含有两种或两种以上的恶性生殖细胞成分。

Fig.1.117 Mixed germ cell tumour. Mixed germ cell tumour containing immature teratoma (neuroectodermalrosettes composed of primitive cells), embryonal carcinoma(glandular proliferation of highly atypical cells), and yolk sac tumour (microcystic pattern).

图1.117混合性生殖细胞肿瘤。混合性生殖细胞瘤包括含有未成熟畸胎瘤(由原始细胞组成的神经外胚层菊形团，胚胎性癌(高度非典型细胞的增生腺体)和卵黄囊瘤(微囊型)。