右鼻腔纤维组织细胞瘤

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患者男性,30岁,一年来右鼻腔阻塞,进行性加剧。体检发现右鼻前庭外上方有一表面光滑的肿块。临床诊断右鼻下甲囊肿。切除标本分别为1×0.8×O.4cm及0.6×0.5×0.3cm,灰白色。镜下见肿瘤组织由三种成分组成:1.肿瘤细胞以梭形为主,核卵圆形,核染色质细,可见一偏位核仁,胞浆稀疏,瘤细胞排列欠规则,无明显席纹样结构可见,其间参杂有组织细胞。2.多核巨细胞散在瘤组织实质内,部分巨细胞核排列于周边,颇似托通氏巨细胞,另一部分核集中于细胞中央,似异物巨细胞。3.散在分布有玻璃样变性的纤维间质及血管。网状纤维染色示网状纤维弥漫增加,瘤细胞与血管关系并不密切。讨论一致同意本例为良性肿瘤。但对类型有分歧:1.本瘤血管丰富,可能为血管外皮瘤。2.本瘤中另有梭形细胞成分,应考虑血管纤维瘤。由于 The patient was male, 30 years old. He had obstructed the right nasal cavity for one year and was progressively worsened. Physical examination revealed a smooth surface above the right nasal vestibule. Clinical diagnosis of right subnasal nail cyst. Resection specimens were 1×0.8×O.4 cm and 0.6×0.5×0.3 cm, respectively, and were off-white. Microscopically, the tumor tissue consists of three components: 1. Tumor cells are spindle-shaped, nuclear oval, fine nuclear chromatin, showing a partial nucleoli, sparse cytoplasm, irregular arrangement of tumor cells, no obvious The structure of the striated pattern can be seen, with mixed tissue cells in between. 2. Multinucleated giant cells scattered in the parenchyma of the tumor tissue, some of the giant cell nucleus arranged in the periphery, quite like giant Tontron cells, and the other part of the nucleus concentrated in the center of the cell, like foreign giant cells. 3. Disseminated with vitreous degeneration of fibrous stroma and blood vessels. The reticular fiber staining showed a diffuse increase in reticular fibers, and the tumor cells were not closely related to blood vessels. The discussion agreed that this case is benign. However, there are disagreements on the type: 1. The tumor is rich in blood vessels, which may be hemangiopericytoma. 2. Another spindle cell component in this tumor should be considered angiofibroma. due to
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