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目的探讨颗粒细胞瘤(GCT)的临床病理特征、鉴别诊断及预后。方法复习11例GCT的临床资料,进行组织细胞形态和免疫组化观察。结果 11例颗粒细胞瘤均为良性,男性5例,女性6例;年龄24~61岁,平均46.2岁。肿瘤直径0.8~6 cm,平均直径2.3 cm,均为单发病例。临床主要表现为真皮、皮下或黏膜下孤立无痛性结节。组织学特点为无明显被膜,瘤细胞体积较大,呈圆形,胞质丰富,可见较多嗜伊红均质细颗粒。免疫组化示肿瘤细胞NSE、S-100及CD68均为强(+),vimentin部分(+),9例不同程度TFE3(+);CK、CD34、SMA、GFAP和NF均为(-)。随访3个月~5年,均无复发和远处转移。结论 GCT为一种少见的良性软组织肿瘤,典型的组织学表现结合免疫组化可以明确诊断。TFE3是诊断GCT有价值的免疫组化标记物。手术切除为首选治疗方法,总体预后良好。
Objective To investigate the clinicopathological features, differential diagnosis and prognosis of granulosa cell tumor (GCT). Methods The clinical data of 11 cases of GCT were reviewed, and the morphology and immunohistochemistry of the cells were observed. Results 11 cases of granulosa cell tumors were benign, 5 males and 6 females; aged 24 to 61 years, mean 46.2 years. Tumor diameter 0.8 ~ 6 cm, the average diameter of 2.3 cm, are single cases. The main clinical manifestations of dermis, subcutaneous or submucosal isolated painless nodules. Histologically characterized by no obvious capsule, tumor cells larger, round, rich in cytoplasm, showing more eosinophilic homogeneous fine particles. Immunohistochemistry showed that the tumor cells were strongly (+), vimentin (+) and TFE3 (+) in 9 cases with varying degrees of NSE, S-100 and CD68; Follow-up 3 months to 5 years, no recurrence and distant metastasis. Conclusion GCT is a rare benign soft tissue tumor. The typical histological findings combined with immunohistochemistry can confirm the diagnosis. TFE3 is a valuable immunohistochemical marker for the diagnosis of GCT. Surgery as the preferred treatment, the overall prognosis is good.