腮腺脂肪瘤样多形性腺瘤的诊断与治疗分析  

Diagnosis and treatment of lipomatous pleomorphic adenoma in the parotid gland

作　　者：吴俊伟[1] 丁旭宣[1] 杨磊[1] 

机构地区：[1]佛山市中医院口腔医疗中心,广东佛山528000

出　　处：《广东牙病防治》2015年第5期271-273,共3页Journal of Dental Prevention and Treatment

摘　　要：目的探讨腮腺脂肪瘤样多形性腺瘤的病理特点、免疫组织化学特点、诊断标准和有效治疗手段。方法腮腺脂肪瘤样多形性腺瘤患者2例,行瘤体加瘤周5 mm部分腺体摘除术,术后肿物标本行常规病理学和免疫组织化学检查;患者术后随诊26~36个月,观察预后情况。结果常规病理镜下见肿瘤组织包膜完整,肿瘤实质由黏液软骨样基质、脂肪组织及肌上皮细胞构成;脂肪组织弥漫均匀分布于瘤组织内,呈蜂窝状结构。免疫组织化学检查发现肿瘤组织发现,胶质纤维酸性蛋白（glial fibrillary acidic protein,GFAP）在肌上皮细胞胞浆阳性表达;S-100蛋白表达阳性,主要在脂肪细胞表达;上皮膜抗原（epithelial membrane antigen,EMA）阳性,胞膜表达,主要在内层导管细胞表达;细胞角蛋白AE1/AE3阳性;细胞核增殖抗原Ki-67在细胞核的阳性表达率1%;患者术后随诊期内未见肿物复发。结论病理和免疫组织化学检查是确诊腮腺脂肪瘤样多形性腺瘤的依据,手术是治疗本病的有效手段。Objective To investigate the pathological features, immunohistochemical, diagnosis and effective treat- ment of lipomatosuspleomorphic adenoma. Methods 2 cases clinically diagnosed with lipomatosusparotid pleomorphic adenoma, underwent peritumoral 5mm ＋ line part of the gland excision, and tissue samples were analyzed by histologi- cal, immunohistochemical examination; postoperative follow-up lasted 36 months. Results The pathologic results （mi- croscopic） ： Enrolled with intact capsule, tumor tissue was constituted with the essence of cartilage like matrix, adipose tissue and myoepithelial cell; adipose tissue uniform distributed in tumor tissue, with honeycomb structure. Immunohisto- chemical examination：found that tumor tissue in GFAP （ ＋ ） for myoepithelial expression, cytoplasmic positive expres- sion; S-100 （ ＋ ） was mainly expressed in the fat cells; EMA （ ＋ ）, the expression of cell membrane, epithelial mem- brane antigen, in the film was mainly expressed in the inner duct cells; AEI/AE3 （ ＋ ） , 1% Ki-67 （ ＋ ）, prokaryotic expression, proliferation index; postoperative follow-up period showed no tumor recurrence. Conclusion Pathological and immunohistochemical examination was an effective method to diagnose lipomatous parotid pleomorphic adenoma, op- eration is the most effective method to cure the disease.

关 键 词：腮腺肿瘤 病理学 脂细胞 脂肪瘤样多形性腺瘤 腮腺 脂肪细胞 

分 类 号：R739.8[医药卫生—肿瘤]