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患者男性,26岁,住院号66788。于1984年5月发现左耳前有一包块,无疼痛,近期增大,在当地用外敷药治疗,引起表面溃破,后经治疗愈合,于1984年8月17日收入我院五官科。检查:左面耳前区明显隆起,轻度压痛,在局麻下行肿物切除术。临床诊断:涎腺混合瘤恶变。病理检查:2.5×3.5×4cm肿物,表面不光滑,与周围组织粘连,包膜不完整,切面灰红色,质软呈鱼肉状。镜下:细胞呈长梭状形,细胞浆丰富,淡粉红色;胞核较大呈长形,两端钝,深色质粗颗粒状,体积和形状皆不一致,核分裂象易见。瘤细胞作错综和漩涡状排列及栅栏状排列,部分区域呈多形性。肿瘤作多处取材,切片,镜下观察均为单一的平滑肌肉瘤成分,无癌的成分,无粘液样或软骨样组织。VG
The patient was male, 26 years old, hospital number 66788. In May 1984, he discovered that there was a mass in front of the left ear, no pain, and it was recently enlarged. He was treated with topical drugs in the local area and caused surface ulceration, healed after healing, and he was admitted to the Department of ENT in our hospital on August 17, 1984. Examination: The front ear area of the left ear is obviously uplifted, mildly tender, and a tumor resection is performed under local anesthesia. Clinical diagnosis: Mixed tumors of the parotid glands are malignant. Pathological examination: 2.5 × 3.5 × 4cm mass, the surface is not smooth, with the surrounding tissue adhesion, the capsule is incomplete, cut surface grayish red, soft and fishy. Microscope: The cells are long spindle-shaped, with rich cytoplasm and pale pink; the nucleus is long and long, blunt at both ends, dark and coarse granular, inconsistent in size and shape, and the mitosis is easy to see. The tumor cells are intricately arranged and whirlpool-like and palisade-like, and some areas are polymorphic. Tumors were obtained from multiple sites, sectioned and microscopically observed as single leiomyosarcoma components, no cancerous components, and no mucinous or cartilage-like tissue. VG