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Histopathological challenges in assessing borderline ovarian tumours

机译：评估卵巢交界性肿瘤的组织病理学挑战

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The diagnosis of borderline ovarian tumours is problematic. Traditionally, the absence of stromal invasion has distinguished borderline ovarian tumours from their malignant counterparts. The recent recognition of microinvasion associated with borderline neoplasms, the analysis of peritoneal implants (PIs), and issues associated with tumour nomenclature contribute to this diagnositc challenge. Furthermore, a proposed reclassification of serous ovarian tumours abandoning the borderline category in favour of atypical proliferative serous tumour (APST) and micropapillary serous carcinoma (MPSC); the latter being subdivided into invasive (invasive MPSC or low-grade serous carcinoma) and non-invasive (non-invasive MPSC or intraepithelial low-grade serous carcinoma) variants, has resulted in the inconsistent use of tumour nomenclature. To facilitate understanding, both the old and new terminologies of serous tumours will be used in this review. Unfortunately, diagnostic dilemmas are not restricted to serous ovarian tumours, in mucinous ovarian tumours, benign, borderline and malignant epithelium can co-exist in the same lesion and metastatic mucinous carcinoma from the gastrointestinal tract can mimic a primary mucinous ovarian tumour. Pseudomyxoma peritonei, which was originally considered as the peritoneal lesion (or implant) associated with a borderline mucinous ovarian tumour, is now believed to be secondary to a low-grade primary mucinous tumour of the appendix. Finally, accurate and complete histological assessment requires the pathologist to be aware of newly described lesions e.g. the seromucinous tumours. In this article, the difficulties associated with the histological diagnosis of the above tumours will be considered with emphasis on the identification of early invasion. 2006 Elsevier Ltd. All rights reserved.
机译：交界性卵巢肿瘤的诊断存在问题。传统上，不存在基质浸润已将边缘性卵巢肿瘤与恶性卵巢肿瘤区分开。最近对与边界肿瘤相关的微浸润的认识，腹膜植入物（PIs）的分析以及与肿瘤命名相关的问题都对这一诊断挑战做出了贡献。此外，提议对浆液性卵巢肿瘤进行重新分类，放弃边缘性分类，转而采用非典型增生性浆液性肿瘤（APST）和微乳头浆液性癌（MPSC）;后者又分为浸润性（浸润性MPSC或低度浆液性癌）和非浸润性（非浸润性MPSC或上皮内低度浆液性癌）变体，导致肿瘤命名法的使用不一致。为便于理解，本综述将使用浆液性肿瘤的新旧术语。不幸的是，诊断难题并不局限于浆液性卵巢肿瘤，在粘液性卵巢肿瘤中，良性，交界性和恶性上皮可以共存于同一病灶中，并且来自胃肠道的转移性粘液性癌可以模仿原发性粘液性卵巢肿瘤。腹膜假单胞菌最初被认为是与边缘粘液性卵巢肿瘤有关的腹膜病变（或植入物），现在被认为是阑尾的低度原发性粘液性肿瘤继发性。最后，准确而完整的组织学评估要求病理学家注意新近描述的病变，例如：浆液性肿瘤。在本文中，将考虑与上述肿瘤的组织学诊断相关的困难，并着重于早期侵袭的鉴定。 2006 Elsevier Ltd.保留所有权利。

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