鼻腔小细胞恶性肿瘤26例临床病理分析  

Small cell malignant tumor of nasal cavity:a clinicopathological analysis of 26 cases

作　　者：李赞[1] 张真真[2] 张声[2] 陈余鹏 

机构地区：[1]福建医科大学附属第三医院病理科,福州350005 [2]福建医科大学附属第一医院病理科,福州350005

出　　处：《临床与实验病理学杂志》2013年第2期175-179,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨鼻腔小细胞恶性肿瘤的病理形态学和免疫组化染色的特点。方法收集26例鼻腔小细胞恶性肿瘤,通过常规HE及免疫组化染色进行观察。结果恶性黑色素瘤11例,可见突出的嗜酸性核仁、核沟、核内假包涵体,表达S-100蛋白、HMB-45、Melan-A。嗅神经母细胞瘤7例,可见神经原纤维、菊形团结构,NSE、Syn阳性,S-100蛋白在肿瘤周边的支持细胞中表达。横纹肌肉瘤4例,瘤细胞多嗜酸性,desmin、vimentin、MyoDl、Myogenin阳性。小细胞神经内分泌癌2例,可见较多的凋亡、坏死和出血,NSE、Syn、CgA均阳性。骨外Ewing肉瘤/原始神经外胚层肿瘤2例,可见Homer-Wright假菊形团及乳头状结构,CD99、vimentin、Syn、NSE均阳性。结论鼻腔小细胞恶性肿瘤具有相似的临床和形态学表现,因此,只有根据其各自的形态学和免疫组化染色特点,才可做出正确的诊断及鉴别诊断。Purpose To study the characteristics of pathologic alterations and immunohistochemical staining of small cell malignant tumor in the nasal cavity. Methods Twenty-six cases of small cell malignant tumor in the nasal cavity were collected and analyzed by using histological observation and immunohistochemical staining. Results Eleven cases were malignant melanoma which had promi- nent eosinophilic nucleoli, nuclear grooves, nuclear pseudoinclusions, and expressed S100 protein, HMB-45 and Melan-A. 7 cases were olfactory neuroblastoma. They had fibrillary cell processes, and NSE and Syn expression, in which there were S-100 positive sus- tentacular cells. 4 cases were rhabdomyosarcoma, which had eosinophilic cytoplasm and the expression of desmin, vimentin, MyoD1 and myogenin. 2 cases were small cell carcinoma, neuroendocrine type, which exhibited extensive apoptosis, confluent necrosis and hemorrhage and the expression of NSE, Syn and CgA. 2 cases were Ewing＇ s sarcoma/primitive neuroectodermal tumor which had Ho- mer-Wright rosettes and pseudopapillary architecture. They expressed CD99, vimentin, Syn and NSE. Conclusions Small cell malig- nant tumor in the nasal cavity may have overlapping clinical and pathologic findings. It is very important to establish the correct diagno- sis and differential diagnosis based on the different histopathological and immunohistochemical characteristics of the tumor.

关 键 词：鼻腔肿瘤 小细胞肿瘤 病理学 诊断 鉴别诊断 

分 类 号：R739.62[医药卫生—肿瘤]