口腔颌面部成人型横纹肌瘤3例临床病理分析  

Adult rhabdomyoma in the oral and maxillofacial region: a clinicopathologic study of three cases

作　　者：张磊[1] 杨艳[1] 陈盛[1] 周婷[2] 王毓佳[2] 黄晓峰[1] 

机构地区：[1]南京大学医学院附属口腔医院/南京市口腔医院口腔病理科,南京210008 [2]南京大学医学院附属口腔医院/南京市口腔医院口腔颌面外科,南京210008

出　　处：《临床与实验病理学杂志》2017年第2期161-164,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：江苏省卫生厅面上科研课题(H201344);江苏省卫计委住院医师规范化培训课题(C2016033)

摘　　要：目的探讨口腔颌面部成人型横纹肌瘤的临床病理学特征。方法对3例口腔颌面部成人型横纹肌瘤的临床资料、影像学、病理学特征、鉴别诊断、治疗及预后进行回顾性分析,并复习相关文献。结果 3例成人型横纹肌瘤,发病年龄4~83岁;男性2例,女性1例;2例发生于口底,1例发生于舌腹。临床表现为缓慢生长的无痛性包块。眼观:肿块呈结节分叶状,切面棕红色,界限清楚。镜检:肿瘤由排列紧密的嗜酸性或透明的大圆形或多边形细胞构成,胞质内可见横纹及空泡。瘤细胞表达desmin和Myoglobin,灶性表达SMA、Myo D1和S-100蛋白;PAS染色呈阳性,可被淀粉酶消化。结论病理检查是诊断成人型横纹肌瘤的主要方法,胞质中的横纹结构与肌源性蛋白的免疫组化染色是诊断的主要依据。手术完整切除是有效的治疗方法,预后好。Purpose To investigate the clinicopathologieal features of the adult rhabdomyoma （A-RM） in the oral and maxillofaeial region. Methods Three cases of A-RM in the oral and maxillofacial region were analyzed for the clinical symptoms, imaging data, pathological features, differential diagnosis, treatment, and prognosis with the literatures review. Results The age arranged from 4 years to 83 years in three A-RM cases. Two cases were male and one case was female. Two eases occurred in the mouth floor and one case in the tongue. Three A-RM cases presented as slowly growing, painless masses clinically. The masses were lobular, red-brown nodules with clear boundary. Histologically, they consisted of densely packed, large, round and polygonal cells with abundant granular eosinophilic cytoplasm. Cross striations and vacuoles were seen in the cytoplasm. Tumor cells expressed desmin and myoglobin, partially expressed SMA, MyoD1 and S-100 protein. PAS was also positive among tumor cells and could be digested by the diastasum diastace. Conclusion Histological examination is the main diagnostic basis for A-RM. For accurate diagnosis, cross striations and immunohistochemistry for myogenic proteins in cytoplasm are of pivotal importance. Radical resection is the main treatment with generally promising prognosis.

关 键 词：软组织肿瘤 成人型 横纹肌瘤 病理学特征 免疫组织化学 

分 类 号：R739.8[医药卫生—肿瘤]