廖艳芳,卢善明,黄 冠,赵海燕,赵雅立

目的：探讨男性纵隔原发性绒毛膜癌并肺转移的临床症状、病理特征、诊疗过程及预后。方法：回顾分析1例确诊男性纵隔原发性绒毛膜癌并肺转移的影像学、组织学、免疫组化，同时结合文献总结男性纵隔原发性绒毛膜癌并肺转移的病理诊断要点与临床预后的关系。结果：青年男性，体检发现右前上纵隔占位及双肺多发转移灶1天。低倍镜下，见出血、坏死，其中有少数肿瘤细胞呈簇团状或小片状分布。高倍镜下，瘤组织由中等大小、胞质透明的细胞(细胞滋养层细胞)和大而异型、胞质丰富、粉染或空泡状的多核巨细胞(合体滋养层细胞)构成。免疫表型：细胞角蛋白（CK7）、β-人类绒毛膜促性腺激素（β-hCG）、P53阳性，甲胎蛋白（AFP）、TTF -1、CD30、OCT -4、P63和P57均阴性，Ki-67 增殖指数约90%。结论：纵隔原发性绒毛膜癌的诊断依赖于血β-hCG、病理学形态及免疫表型，及早采用规范化学治疗结合手术治疗，患者可获得较高的生存率。

纵隔；绒毛膜癌；人类绒毛膜促性腺激素；病理特征

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