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目的探讨扁桃体滤泡树突状细胞肉瘤(FDCS)的临床病理学特点和生物学行为。方法对1例扁桃体FDCS进行病理学观察和免疫组化标记并复习文献进行讨论。结果患者女性,23岁。咽喉疼痛2个月。巨检:肿瘤最大直径2.5 cm。镜检:隐约结节状。瘤细胞胖梭形和卵圆形,核膜清晰,细胞分界不清;细胞核中度异型,有少量瘤巨细胞和R-S样细胞;核分裂象>5个/10 HPF。肿瘤细胞排列成条束状、旋涡状、席纹状。免疫组化:肿瘤细胞CD21和CD35(+)。术后行放、化疗。1年半随访,肿瘤无复发和转移。结论FDCS肿瘤细胞特征性表达CD21和/或CD35。扁桃体FDCS要与口腔常见类型的梭形细胞肿瘤(如纤维组织细胞瘤、炎症性肌纤维母细胞瘤、肌上皮瘤和梭形细胞癌等)鉴别。FDCS大多为低度恶性,复发率较高。
Objective To investigate the clinicopathological characteristics and biological behavior of tonsillar follicular dendritic cell sarcoma (FDCS). Methods One case of tonsil FDCS was observed by pathology and immunohistochemistry and reviewed the literature. Results Female patient, 23 years old. Sore throat for 2 months. Giant examination: the largest tumor diameter of 2.5 cm. Microscopic examination: vague nodular. Tumor cells were spindle-shaped and oval, clear nuclear membrane, unclear cell boundaries; nucleus moderately shaped, a small amount of tumor giant cells and R-S-like cells; mitosis> 5/10 HPF. Tumor cells arranged in a bundle, whorls, stripes. Immunohistochemistry: tumor cells CD21 and CD35 (+). After surgery, chemotherapy. 1 year and a half years follow-up, no tumor recurrence and metastasis. Conclusion FDCS tumor cells express CD21 and / or CD35 characteristicly. Tonsillar FDCS should be identified with common forms of spindle-cell tumors of the oral cavity such as hemangioblastoma, inflammatory myofibroblastoma, myoepithelioma, and spindle cell carcinoma. FDCS are mostly low-grade, high recurrence rate.