颗粒细胞瘤43例临床病理分析  

Granular cell tumors: a clinicopathologic analysis of 43 cases

作　　者：何珏[1] 王天科[2] 

机构地区：[1]赣南医学院病理学教研室,江西赣州341000 [2]温州医科大学附属慈溪医院病理科,浙江宁波315300

出　　处：《诊断病理学杂志》2015年第11期692-696,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨颗粒细胞瘤(GCT)的临床病理特征,以提高对该肿瘤的认知和诊断水平。方法应用常规病理学技术、免疫组化Polink-2HRP染色系统对43例软组织颗粒细胞瘤进行石蜡切片、HE及免疫组化染色分析,其中15例结合术中快速冷冻切片形态。依据WHO(第4版)软组织肿瘤分类诊断标准对其病理特征进行综合分析。结果 43例GCT中38例光镜下肿瘤细胞为多边形,呈巢片状排列,细胞间为胶原纤维束,胞核小、圆或卵圆形,胞质内见嗜伊红颗粒;5例细胞呈梭形,丰富密集。肿瘤与周围组织无明显边界;免疫组化:S-100、CD56、Syn、NSE、vimentin及CD68(+),CK、GFAP、desmin及Melan A(-);术中快速冷冻切片会诊9例GCT、1例误诊为恶性、5例延迟;常规病理诊断:40例GCT、3例非典型GCT。结论 GCT是较少见的外周神经组织肿瘤,准确及时的病理诊断,是保证临床治疗效果的关键。Objective To investigate the clinicopathological features of granular cell tumor（ GCT） to improve its diagnosis. Methods The 43 cases of GCTs were embedded in paraffin,sectioned,and HE-stained with the conventional pathological techniques and immunohistochemical markers of Polink-2HRP were conducted in all the cases,including 15 cases with frozen section during operation. After that,their pathological features were comprehensively analyzed based on the diagnostic criteria of the WHO Soft Tissue Tumor Classification（ 4th Edition）. Results Under light microscope,38 of 43 GCTs featured polygonal tumor cells,nest or sheet arrangement,with intercellular collagen bundles; the tumor cells had a small and round nucleus with eosinophilic grandular periplasm. The spindle cells were densely arranged in 5 cellular tumors without clear boundary with the surrounding tissues. Immunohistochemical satining showed that tumor cells were positive for S-100,CD56,SYN,NSE,vimentin and CD68,but negative for CK,GFAP,desmin and Melan A.Intraoperative frozen section diagnosis was that： 9 cases were GCTs,1 was mistakenly diagnosed as malignancy and 5 were deferred. Conventional pathological diagnosis was that 40 cases were GCTs and 3 atypical GCTs. Conclusion GCT is a rare peripheral nerve tissue tumor. Accurate and timely pathological diagnosis is key to the clinical treatment.

关 键 词：颗粒细胞瘤 病理诊断 免疫组化 

分 类 号：R738.6[医药卫生—肿瘤]