We investigated the frequency and associated pathology of embryoid bodies in ovarian tumors by evaluating neoplasms in which they are known to occur: 100 immature teratomas, 125 malignant mixed germ cell tumors, and 6 polyembryomas. Three immature teratomas contained a single relatively well-formed embryoid body, whereas these and 11 others showed foci we categorized as embryoid body remnants consisting of microscopic aggregates of embryonal or yolk sac-type epithelium associated with spaces consistent with yolk sac or amniotic cavity but lacking a classic embryoid body structure. Teratomas with these foci were all high grade. A well-formed embryoid body was found in only 1 malignant mixed tumor, but embryoid body remnants were present in 25%, invariably associated with foci of immature teratoma (100%) and often with yolk sac tumor (97%), embryonal carcinoma (35%), or both (32%). These foci usually took the form of round to oval aggregates, often well-circumscribed, for which the term "polyembryoma background" has been proposed. The polyembryomas were typically grossly hemorrhagic and occurred in patients from 9 to 43 years of age. The embryoid bodies in them generally grew in lobules within an edematous to occasionally myxoid stroma. Four tumors contained liver-like cells, 4 numerous glands likely recapitulating the allantois, 3 syncytiotrophoblast cells, 2 prominent cysts, and 2 striking vascular proliferations. This study indicates that (1) typical embryoid bodies are rare in immature teratomas but about 14% of them have embryoid body remnants. (2) Embryoid body remnants are seen in 25% of malignant mixed germ cell tumors with a teratomatous component and often proliferate to form yolk sac tumor and embryonal carcinoma. (3) Well-formed embryoid bodies growing in a confluent manner (polyembryoma) are rare, and minor foci of teratoma, yolk sac tumor, or embryonal carcinoma are almost always present, indicating that these are fundamentally malignant mixed germ cell tumors but the polyembryoma component is dominant and distinctive which, in our opinion, justifies its own nomenclature. (4) Embryoid bodies are not a feature of other germ cell tumors.

中文翻译：

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卵巢生殖细胞肿瘤中的胚状体和相关增殖。


我们通过评估已知发生胚状体的肿瘤，研究了卵巢肿瘤中胚状体的频率和相关病理学：100 个未成熟畸胎瘤、125 个恶性混合生殖细胞肿瘤和 6 个多胚瘤。三个未成熟畸胎瘤包含一个相对良好的胚状体，而这些和其他 11 个则显示出我们归类为胚状体残余物的病灶，由胚胎或卵黄囊型上皮的微观聚集体组成，这些上皮细胞与与卵黄囊或羊膜腔一致但缺乏的空间相关。经典的胚状体结构。具有这些病灶的畸胎瘤均为高级别畸胎瘤。仅在 1 例恶性混合瘤中发现形态良好的胚状体，但 25% 存在胚状体残留，总是与未成熟畸胎瘤病灶 (100%) 相关，并且经常与卵黄囊肿瘤 (97%)、胚胎癌 (97%) 相关。 35%），或两者兼而有之（32%）。这些病灶通常呈圆形到椭圆形聚集体的形式，通常界限清楚，为此提出了术语“多胚瘤背景”。多胚胎瘤通常会严重出血，发生在 9 至 43 岁的患者中。其中的胚状体通常在水肿至偶尔粘液样基质内的小叶中生长。 4 个肿瘤含有肝样细胞、4 个可能再现尿囊的众多腺体、3 个合体滋养层细胞、2 个明显的囊肿和 2 个显着的血管增生。本研究表明：（1）未成熟畸胎瘤中典型的拟胚体很少见，但约14%有拟胚体残留。 (2) 25%的具有畸胎瘤成分的恶性混合生殖细胞肿瘤中可见胚样体残留，常增殖形成卵黄囊瘤和胚胎癌。 (3) 以汇合方式生长的形态良好的胚状体（多胚瘤）很少见，畸胎瘤、卵黄囊瘤或胚胎癌的小病灶几乎总是存在，表明这些本质上是恶性混合生殖细胞肿瘤，但多胚瘤我们认为，该成分具有主导性和独特性，这证明了其自己的命名法的合理性。 (4)胚样体不是其他生殖细胞肿瘤的特征。