颗粒细胞瘤14例临床病理学观察与文献复习  

Granular cell tumor——A clinicopathologic study of fourteen cases with review of literature

作　　者：王秋鹏[1] 甘梅富 王四玲[1] 张建伟 周涛 

机构地区：[1]浙江省恩泽医疗中心台州市中心医院病理科,浙江台州318000 [2]浙江省恩泽医疗中心台州医院病理科,浙江台州317000

出　　处：《实用肿瘤杂志》2011年第5期510-513,共4页Journal of Practical Oncology

摘　　要：目的探讨颗粒细胞瘤(granular cell tumor,GCT)的临床病理特征,并提高对颗粒细胞瘤的认识。方法分析2006年至2010年台州医院收治的14例颗粒细胞瘤临床病理资料。结果 14例均表现为皮下或深部软组织无痛性的孤立性肿块。肿瘤位于食管6例,腰部及胸背部3例,左下腹壁1例,左上臂1例,阴囊1例,左肺上叶支气管1例,右肺上叶支气管1例。肿瘤直径0.3～4 cm,平均1.3 cm。镜下14例GCT形态相似,肿瘤由呈巢或片状排列的圆形或多边形细胞组成,胞质呈嗜伊红细颗粒状。免疫组织化学S-100和NSE阳性,1例CD68弱阳性,Desmin、CK阴性。14例GCT中13例良性1,例细胞不典型性。1例不典型病例及5例良性病例呈膨胀性生长,另8例良性病例呈浸润性生长。11例经随访5-38月,均未见复发和转移3,例失访。结论颗粒细胞瘤为一种少见的具有雪旺细胞分化的软组织肿瘤,可发生于任何部位。临床及形态学容易误诊,免疫组织化学标志对鉴别诊断具有重要意义。Objective To study clinicopathologic features and to enhance the acquaintance of granular cell tumor（GCT）. Methods Fourteen cases were collected from Enze Medical Center Taizhou Hospital from 2006 to 2010 and analyzed with review of clinical data and pathologic features. Results The main presenting symptom was painless nodule and located in the subcutis or deep soft tissue.The tumors occurred in the esophagus in 6 patients,in the waist and chest back in 3,and in the low left abdominal wall,upper left arm,scrotum,left superior lobar bronchus,right superior lobar bronchus in one each.The tumor size ranged from 0.3~4 cm（mean size=1.3 cm）.Microscopically,the tumor was composed of nests or sheets of polygonal or round cells which were full of abundant eosinophilic granular cytoplasm.Immunohistochemically,the tumor cells were positive for S-100,NSE,weak positive in one case for CD68,while negative for Desmin,CK.Thirteen cases had typical histological features,while one case had atypical features.Growth patterns were invasive in 8 cases and expansive in 6,including 1 atypical case.Recurrence or metastasis was not detected in all 11 cases during 5-38 months of follow-up. Conclusions GCT is a rare neoplasm of soft tissue originated from Schwann cell,and may locate in every part of the body.Clinically and morphologically GCT is easy to misdiagnose,and the immunohistochemistry is helpful for the differential diagnoses.

关 键 词：颗粒细胞瘤/病理学 软组织肿瘤 诊断 鉴别 随访研究 免疫组织化学 

分 类 号：R737.31[医药卫生—肿瘤]