牙源性钙化上皮瘤3例临床病理观察  

Calcifying epithelial odontogenic tumour: a clinicopathological analysis of three cases

作　　者：付文荣[1] 程正江[1] 

机构地区：[1]湖北文理学院附属襄阳市中心医院,湖北襄阳441021

出　　处：《诊断病理学杂志》2014年第4期231-233,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的对牙源性钙化上皮瘤的病理诊断、鉴别诊断和预后进行分析。方法用光镜观察、免疫组化、特殊染色对3例牙源性钙化上皮瘤进行临床病理分析,并复习相关文献。结果 3例牙源性钙化瘤中2例位于下颌骨内,1例位于上颌骨内。镜下肿瘤由纤维间质和多边形上皮细胞岛及团片构成。肿瘤细胞含丰富的嗜酸性胞质,细胞间界限非常清楚,有分化良好的细胞间桥;细胞核常呈多形性,巨型核常见,核分裂象罕见。在肿瘤细胞团片中央或其外周,可见嗜酸染色的、均一的透明物质,刚果红染色显示为淀粉样物,并常以同心圆的方式发生钙化。钙化是该肿瘤的特征。免疫组化:上皮细胞p63和HCK(+)。随访:1例术后6年复发,1例术后2年无复发,1例术后恢复中。结论牙源性钙化上皮瘤较少见,肿瘤有独特的病理组织学特点,可向局部侵袭性生长,需要与骨内原发或转移的鳞状细胞癌、涎腺的恶性肿瘤(包括黏液表皮样癌和腺泡细胞癌)、肾透明细胞癌转移等相鉴别。手术切除不彻底可复发,建议临床长期随访。Objective To analyse the pathological diagnosis, differential diagnosis and prognosis of the calcifying epithelial odontogenic tumour （CEOT）. Methods The conventional HE staining, special staining and immunohistochemistry were used to analyse the elinicopathologieal features of 3 cases of the calcifying epithelial odontogenic tumour, and follow-up had been done. Results Two cases of CEOT oeeured in mandible, and 1 case in maxilla. Microscopically, the tumor consisted of epithelioid islet or sheets and fibrous stroma. In the center or outer periphery of the tumor mass, the substance with eosinophilic staining and uniform transparence was observed, and Congo red staining showed that the transparent substance was amyloid-like material, which was calcified in the manner of concentric circle. Immunohistochemistry showed that epithelial cells expressed P63 and HCK. Six years after surgery, the tumor in one patient was recurred, one patient without recurrence, and one patient was free of tumor. Conclusion Odontogenic calcifying epithelioma is a rare odontogenic tumor, wich has unique histopathological characteristics, with locally aggressive growth. It needs to be differentiated from the primary or metastatic bone squamous cell carcinoma, salivary gland malignant tumors including mucoepidermoid carcinoma and acinar cell carcinoma, and renal cell metastasis carcinoma.

关 键 词：牙源性钙化上皮瘤 病理诊断 预后 

分 类 号：R739.82[医药卫生—肿瘤]