请教：1.这类的输卵管系膜囊肿很常见，发（副）中肾管囊肿、卵巢冠囊肿、泡状附件等，大家是怎么对这类囊肿发报告的？

2.这一例在囊肿旁有桑葚样的细胞，是什么呢？意义？？

walthard cell nest may be either solid or cystic.it is a kind of urothelial or squamous metaplasia from mesothelium.可以是实性，也可以是囊性，所以囊肿不能被看做中肾管囊肿。

 细胞团为Walthard细胞巢的话，囊肿会不会是细胞团为Walthard细胞囊肿，

Walthard cell nests on laparoscopy

P.G. Paul, MBBS, DGO, Aby K. Koshy, MS, DNB, and Tony Thomas, MS

From Paul’s Hospital, Cochin, Kerala, India (all authors). A 29-year-old woman had secondary infertility of 2 years duration. She had infrequent menstrual cycles and had been treated with multiple cycles of clomiphene citrate. She had no history suggestive of pelvic inflammatory disease. Diagnostic laparoscopy showed multiple small white, discrete papillary nodules on the surface of both tubes and the posterior aspect of  the mesosalpinx, which were biopsied (Figure 1). There was no evidence of endometriosis or any pelvic inflammatory disease. Histopathologic examination revealed cystic and solid Walthard cell nests. Walthard nests are lesions commonly seen on the pelvic peritoneum and may measure a few millimeters in diameter.1 Frequent sites include serosa of the fallopian tubes and the posterior surface of the mesosalpinx. Less commonly, the ovary and the mesovarium may be involved.2 On histologic examination, cells resembling urothelial cells are seen. There are nests of polygonal cells with oval nuclei and scant to moderate amounts of cytoplasm. The cysts often contain eosinophilic or amorphous material. 2,3 Serotonin-immunoreactive cells have been demonstrated with immunohistochemical techniques. 4 Because of the microscopic similarity to urothelium, it has been postulated that Walthard nests arise from metaplasia of mesothelium to transitional or urothelial cells. 2,3 This, however, has been questioned in light of newer studies failing to demonstrate urothelial markers on immunohistochemical staining. 5,6 These lesions are frequently misdiagnosed as tuberculosis, especially in areas of high prevalence. Biopsy is essential to confirm the diagnosis and rule out other peritoneal lesions such as endometriosis and endosalpingosis.

References

1. Bell DA. Pathology of the peritoneum and secondary Mullerian,system. In: Fox H, Wells M, eds. Haines and Taylor Obstetrical and Gynaecological Pathology. 5th ed. Churchill Livingstone; 2003. p.

926-927.

2. Bransilver BR, Ferenczy A, Richart RM. Brenner tumors and Walthard cell nests. Arch Pathol. 1974;98:76–86.

3. Roth LM. The Brenner tumor and the Walthard cell nest: An electron microscopic study. Lab Invest. 1974;31:15–23.

4. Fetissof F, Lansac J. Endocrine cells in Walthard’s cell rests. Ann Pathol. 1988;8:220 –222.

5. Ogawa K, Johansson SL, Cohen SM. Immunohistochemical analysis of uroplakins, urothelial specific proteins, in ovarian Brenner tumors, normal tissues, and benign and metaplastic lesions of the female genital tract. Am J Pathol. 1999;155:1047–1050.

6. Reidel I, Czernobilsky B, Lifschitz-Mercer B, et al. Brenner tumors but not transitional cell carcinomas of the ovary show urothelial differentiation: immunohistochemical staining of urothelial markers, including cytokeratins and uroplakins. Virchows Arch. 2001;438: 181–191.

Corresponding author: Dr Aby K. Koshy, Paul’s Hospital, Vattekkattu Road, Kaloor, Cochin, Kerala, India, 682017.

E-mail: abykkoshy@rediffmail.com.

Submitted March 22, 2006. Accepted for publication May 12, 2006.

Journal of Minimally Invasive Gynecology (2006) 13, 499

Figure 1 Walthard cell nests on the fallopian tube.

Thanks to 海浪信使 for helping upload the picture!

 胚胎残余囊肿。

位于输卵管叫：系膜囊肿；位于卵巢门部，叫：卵巢门囊肿，包括“泡状附件”在内这几个更多的是临床诊断名称。

病理如果可以分开到底是中肾管或副中肾来源则分，分不出分化方向的统称“胚胎残余囊肿”。

发什么无所谓，只要和临床医生达成共识就可以

学习了

walthard细胞巢。

今天遇到的一例卵巢肿瘤术后送检的标本（曾因宫颈癌切除了全子宫，保留了双附件），输卵管无明显异常，常规的取材后，在输卵管的系膜面看见这样的细胞团，手里查阅的书籍对此只有文字描述，没有图片，没想到在这里发现了，感谢楼主，感谢网络：）