耳鼻咽喉头颈部结外Rosai-Dorfman病临床病理特征  

Clinicopathological features of extranodal Rosai-Dorfman disease in head and neck

作　　者：何小金[1] 田澄[1] 杨冬梅[1] 刘红刚[1] 谢新纪[1] 

机构地区：[1]首都医科大学附属北京同仁医院病理科,100730

出　　处：《临床与实验病理学杂志》2010年第4期456-459,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨耳鼻咽喉头颈部结外Rosai-Dorfman病的临床病理学特征、诊断及鉴别诊断。方法收集北京同仁医院5例耳鼻咽喉头颈部结外Rosai-Dorfman病例,并行常规HE、组织化学和免疫组化染色。结果患者年龄37～72岁,平均49岁。5例中原发于喉2例,原发于鼻腔2例,原发于鼻翼皮肤1例。组织病理学特征:①低倍镜下为上呼吸道黏膜下或皮肤真皮内肿瘤细胞弥漫浸润,呈不同程度淡染区和深染区相间交错;②高倍镜下窦组织细胞增生,伴有不同程度其它慢性炎症细胞浸润,可见"伸入现象",病变特征不如结内病变明显;③免疫组化染色结果显示窦组织细胞S-100和CD68阳性,CD1a、CD20、CD45RO阴性。结论耳鼻咽喉头颈部发生的结外Rosai-Dorfman病是一种少见的组织细胞增生性疾病,有特定的组织病理学特征,在诊断上需要和该部位的其他肿瘤和炎性病变鉴别。Purpose To investigate the clinicopathologic features,the diagnosis and differential diagnosis of extranodal Rosai-Dorfman disease in head and neck. Methods Five cases of extranodal Rosai-Dorfman disease in Beijing Tongren Hospital were studied using hematoxylin-eosin,and immunohistochemical staining. Results The 5 cases of Rosai-Dorfman disease consisted of 1 male and 4 females,aged from 37 to 72 years （mean 49 years）. Histopathologically,The lesions of Rosai-Dorfman disease were characterized by the presence of large histiocytes with emperipolesis,accompanied by infiltration of the chronic inflammatory cells. These features of histopathology were less typical than that in lymph nodes. The large sinus histiocytes was positive for S-100 and CD68 protein staining. Conclusions Extranodal Rosai-Dorfman disease in head and neck is known as an idiopathic proliferative disease of histiocytes with a distinct morphologic feature and is very rare. Differential diagnosis from other types of tumor and inflammation lesions is recommended.

关 键 词：ROSAI-DORFMAN病 临床病理 鉴别诊断 

分 类 号：R739.6[医药卫生—肿瘤]