阑尾低级别黏液性肿瘤临床病理探讨  

Clinicopathological discussion on low-grade mucinous tumors of the appendix

作　　者：孙龙[1] SUN Long(Department of Pathology,Qidong People’s Hospital in Jiangsu Province,Qidong Hospital Affiliated to Nantong University,Qidong226200,China)

机构地区：[1]江苏省启东市人民医院南通大学附属启东医院病理科,江苏启东226200

出　　处：《中国现代医生》2020年第16期132-135,F0003,共5页China Modern Doctor

摘　　要：目的分析阑尾低级别黏液性肿瘤的临床特点、病理特征及鉴别诊断。方法收集我院2014年1月~2018年12月收住入院手术后经病理诊断为阑尾低级别黏液性肿瘤的7例患者,分析其病理形态特征、鉴别诊断要点及临床特点。结果7例均有轻重不等的右下腹疼痛,阑尾均有增粗或囊性扩张,切面见有黏液,其中1例浆膜外有黏液。镜下黏膜上皮呈低级别上皮内瘤变,固有层及淋巴滤泡消失,缺乏黏膜肌及黏膜下层,上皮下为纤维性组织,黏液侵入阑尾壁肌层,甚至达浆膜外,1例黏液内有少量低级别上皮,其余6例黏液内没有上皮。结论阑尾低级别黏液性肿瘤具有低度恶性潜能,有复发的可能,有引起腹膜假黏液瘤的风险。手术时应尽量避免肿瘤破裂,尽量把肿瘤清除干净。诊断主要依靠术后病理,同时需做好鉴别诊断。Objective To analyze the clinical characteristics,pathological characteristics and differential diagnosis of low-grade mucinous tumors of the appendix.Methods Seven cases who were admitted to our hospital and diagnosed as low-grade mucinous tumors of the appendix after surgery by pathology from January 2014 to December 2018 were collected.Their pathological morphological characteristics,key points of differential diagnosis and clinical characteristics were analyzed.Results All seven cases had pain in the right lower abdomen with varying degrees of severity,and the appendix was thickened or cystic dilated.There was mucus on the section,and one case had mucus outside the serosal membrane.Under the microscope,the mucosal epithelium showed low-grade intraepithelial neoplasia,and the lamina propria and lymph follicles disappeared.There was a lack of mucosal muscles and submucosa,and under the epithelium was fibrous tissue.Mucus invaded the muscular layer of the appendix wall,even reaching outside the serosal membrane.One case had a small amount of low-grade epithelium in the mucus,and the remaining 6 cases had no epithelium in the mucus.Conclusion Low-grade mucinous tumors of the appendix have low-grade malignant potential,which may cause recurrence and have the risk of causing peritoneal pseudomyxoma.During the surgery,the tumor rupture should be avoided as much as possible,and the tumor should be cleared as much as possible.Diagnosis mainly depends on postoperative pathology,and proper differential diagnosis is required.

关 键 词：阑尾 低级别黏液性肿瘤 病理特征 鉴别诊断 

分 类 号：R735.36[医药卫生—肿瘤]