上颌骨黏液表皮样癌临床病理观察  

Clear cell variant of maxillary mucoepidermoid carcinoma:a clinicopathological analysis

作　　者：徐仟[1] 何春燕[1] 金玉兰[1] 刘红刚[1] XU Qian HE Chun-yan JIN Yu-lan LIU Hong-gang(Department of Pathology, Beijing Tong Ren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China)

机构地区：[1]首都医科大学附属北京同仁医院病理科/头颈部分子病理诊断北京市重点实验室,北京100730

出　　处：《诊断病理学杂志》2016年第11期828-832,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨颌骨中心性透明细胞变异型黏液表皮样癌临床病理特点。方法报道1例中心性透明细胞变异型黏液表皮样癌,回顾分析其临床、影像学、病理组织学特点,探讨其诊断与鉴别诊断。结果患者男性,27岁,3年前发现左侧牙龈出现肿胀,进行左上颌窦囊肿手术,术后病理符合囊肿改变。1月前发现左鼻反复流脓性鼻涕、鼻塞,伴有少量血丝,异味明显。CT示:左侧上颌骨、硬腭占位。术中冷冻:倾向为成釉细胞瘤(滤泡型)。术后诊断:黏液表皮样癌(透明细胞型,中分化)。结论发生在上颌骨的透明细胞变异型黏液表皮样癌十分罕见,病理诊断尤其是术中冷冻极易误诊。确诊有赖于广泛取材、HE、免疫组化及特殊染色的综合判断。Objective To study the clinical and pathological characteristics of clear cell variant of maxillary mucoepidermoid carcinoma. Methods One case of clear cell variant of maxillary mucoepidermoid carcinoma was presented and the relevant clinical data, radiologic findings and pathological characteristics were reviewed. The diagnosis and differential diagnosis were also described. Results A 27-year-old man presented with the chief complaint of left buccal swelling three years ago. Then he was treated with cystic lesion resection of left maxillary sinus and histopathological examination showed a cystic lesion. The patient presented with left nasal flow of repeatedly purulent discharge, nasal congestion, accompanied by a trait of blood and stinky smell since one month. CT showed a mass located in left upper maxillary and palatum durum. Intraoperative frozen section revealed ameloblastoma （follicular type）. Final diagnosis was mucoepidermoid carcinoma （clear cell variant, moderate differentiation）. Conclusion Clear cell variant of maxillary mucoepidermoid carcinoma is a rare disease. Histopathological examination, especially intraoperative frozen section, is more prone to misdiagnosis. The correct diagnosis depends on extensive sampling, histopathological examination, immunohistoehemistry and special staining.

关 键 词：上颌骨 中心性透明细胞变异型黏液表皮样癌 病理诊断 

分 类 号：R739.8[医药卫生—肿瘤]