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目的探讨鼻咽部滤泡树突状细胞肉瘤的临床病理特点、诊断及鉴别诊断要点。方法回顾分析2例鼻咽部滤泡树突状细胞肉瘤的临床表现、影像学、组织病理学特点及免疫组化表型。结果 2例均为女性,年龄分别为53岁和56岁。肿物最大径分别为4.4 cm和4 cm。2例肿瘤均由梭形细胞组成,细胞片状排列,局部略呈车辐状、束状、旋涡状,细胞异型性不明显。免疫组化:vimentin、CD21和CD23均(+),CK(-);例1 EMA(+),CD35(-),EB病毒(+);例2 CD35(+),EMA(-),EBV(-)。例1放弃治疗,随访2个月,目前带瘤生存;例2接受了肿物扩大切除,术后25个月复发,拒绝再次手术,目前带瘤生存32个月。结论鼻咽部滤泡树突状细胞肉瘤非常罕见,明确诊断需结合组织病理学形态、免疫组化表型及EB病毒检测。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of nasopharyngeal follicular dendritic cell sarcoma. Methods Retrospective analysis of 2 cases of nasopharyngeal follicular dendritic cell sarcoma clinical manifestations, imaging, histopathological features and immunohistochemical phenotype. Results 2 cases were female, aged 53 and 56 respectively. The maximum diameter of the tumor was 4.4 cm and 4 cm, respectively. Both tumors were composed of spindle cells, the cells arranged in sheet form, slightly spokes-like, bundles, whirlpool, cell atypia was not obvious. Immunohistochemistry: vimentin, both CD21 and CD23 (+) and CK (-); Example 1 EMA (+), CD35 (-). Example 1 to give up treatment, followed up for 2 months, with the current survival of the tumor; Example 2 received tumor enlargement and excision, recurrence after 25 months, refused to re-surgery, the current tumor survival of 32 months. Conclusions The nasopharyngeal follicular dendritic cell sarcoma is very rare. The diagnosis should be combined with histopathology, immunohistochemical phenotype and Epstein-Barr virus detection.