睾丸网腺癌罕见，其病因和病理学特点还未得到充分研究。因此，我们分析了本单位诊断的6例睾丸网腺癌患者的临床、组织学及免疫组化特征并复习相关文献。患者平均年龄为64岁。所有患者均表现为睾丸肿块，其中4例发生于右侧。大体上，所有肿瘤均发生于睾丸门部，切面为囊实性。组织学上，所有病例均有网状和浸润性生长，并表现为不同比例的乳头状、实性和腺样多种结构，腺样形态可呈现出从裂隙样管腔到形态良好的腺体和小管的多种形态。少见的结构包括条索状/小梁状（n=3）、筛状（n=3）、肾小球样（n=3）、巢状（n=2）和微乳头状（n=2）。其中3例可见分散的嗜酸性和透明细胞巢；3例可见地图样坏死。所有病例至少显示中度的核多形性，细胞核呈卵圆形。所有病例均可见从良性到恶性睾丸网上皮的过渡，间质透明变性，形成局部的纤维化表现。在免疫组化研究中，肿瘤细胞阳性表达CK7（5/5）、AE1/AE3细胞角蛋白（5/5）、EMA（5/5）、波形蛋白（5/5）、EpCAM（通过BerEP4抗体检测）（4/5）、CK5/6（4/5）、WT-1核（4/5）、上皮特异性抗原（通过MOC31抗体检测）（3/4）、PAX8（3/5）和钙网蛋白（2/5）。OCT3/4、SALL4、CD30、NKX3.1、PSA、α-抑制素、CK20和S100蛋白均为阴性。Ki-67增殖指数范围为5%~60%（平均：40%，中位数：43%）。截止目前为止，5例患者发生腹膜后淋巴结转移，其中1例同时伴肺转移。第6例患者在诊断后15个月内发生肺转移。3例患者在确诊后4年内死亡。总之，睾丸网腺癌是1种罕见的恶性肿瘤，存活率低，易于发生腹膜后淋巴结转移，需与其他睾丸肿瘤和睾丸转移性肿瘤鉴别。发生于睾丸门部、从良性到恶性睾丸网上皮的过渡以及支持性免疫组化表达有助于其准确诊断。
Am J Surg Pathol 2019;43:670–681
美国外科病理学杂志中文版2019年第四期摘要NO.4
（苟思琪 翻译 黄文斌 审校）
The American Journal of Surgical Pathology中文版声明：
©2018 Wolters Kluwer Health
The material is published by Wolters Kluwer Health with the permission of American Journal of Surgical Pathology.No part of this publication may be reproduced in any form,stored in a retrieval system or transmitted in any form,by any means,without prior written permission from Wolters Kluwer Health.Opinions expressed by the authors and advertisers are not necessarily those of the American Journal of Surgical Pathology, its affiliates,or of the Publisher.The American Journal of Surgical Pathology,its affiliates,and the Publisher disclaim any liability to any party for the accuracy,completeness,efficacy,or availability of the material contained in this publication (including drug dosages) or for any damages arising out of the use or non-use of any of the material contained in this publication.
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【本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意 ，否则追究法律责任；所有文章仅供公益交流，不代表本站立场。欢迎提供素材、资料等，投稿邮箱： tougao@91360.com，一经采纳将给予稿费】
©2018 Wolters Kluwer Health
The material is published by Wolters Kluwer Health with the permission of American Journal of Surgical Pathology.No part of this publication may be reproduced in any form,stored in a retrieval system or transmitted in any form,by any means,without prior written permission from Wolters Kluwer Health.Opinions expressed by the authors and advertisers are not necessarily those of the American Journal of Surgical Pathology, its affiliates,or of the Publisher.The American Journal of Surgical Pathology,its affiliates,and the Publisher disclaim any liability to any party for the accuracy,completeness,efficacy,or availability of the material contained in this publication (including drug dosages) or for any damages arising out of the use or non-use of any of the material contained in this publication.
Although advertising material is expected to conform to ethical (medical) standards,inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer.
【本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意 ，否则追究法律责任；所有文章仅供公益交流，不代表本站立场。欢迎提供素材、资料等，投稿邮箱： tougao@91360.com，一经采纳将给予稿费】
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