右颊黏膜腺泡状软组织肉瘤1例报告及文献复习  

Alveolar soft part sarcoma of right buccal mucosa:A case report and literature review

作　　者：任美思[1] 范玉[1] 薛庆蕊 王天禹 臧光祥 孙宏晨 REN Meisi;FAN Yu;XUE Qingrui;WANG Tianyu;ZANG Guangxiang;SUN Hongchen(Department of Oral Pathology,Stomatology Hospital,China Medical University,Shenyang 110002,China)

机构地区：[1]中国医科大学附属口腔医院病理科,辽宁沈阳110002

出　　处：《吉林大学学报（医学版）》2021年第5期1281-1286,共6页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金项目(82072998)。

摘　　要：目的:分析右颊黏膜腺泡状软组织肉瘤(ASPS)患者的临床表现、病理诊断、治疗及预后,提高临床医生对ASPS的认识。方法:收集1例ASPS患者的临床和病理资料,总结分析该病的临床特征、病理诊断要点、鉴别诊断、治疗方法及预后,并进行相关文献复习。结果:患者,男性,46岁,因右颊黏膜肿物3个月就诊于当地医院。自觉肿物缓慢增大,无疼痛及其他临床症状。以良性肿物为初步诊断行肿物切除术治疗,术后无明确病理诊断,遂来本医院病理科会诊。组织学形态表现,肿瘤由特征性的内含嗜伊红染色颗粒的多边形或大圆形细胞组成,胞质丰富,排列呈实性结构,未形成任何“腺泡样”或“器官样”结构,可见瘤栓。免疫组织化学染色,广谱细胞角蛋白[CK(p)](-),波形蛋白(Vim)(-),平滑肌肌动蛋白(SMA)(部分+),结蛋白(Desmin)(部分+),核转录因子E3(TFE3)(核+)。结合免疫标记诊断为腺泡状软组织肉瘤(实体型),侵犯血管。该患者术后未接受放化疗,随访5个月无复发和转移。结论:ASPS患者无特异性临床表现和影像学表现,其诊断主要依靠组织形态表现和免疫组织化学染色结果,实体型ASPS更容易误诊。根治性切除是ASPS的主要治疗方法,且患者术后应定期随访。Objective:To analyze the clinical manifestation,pathological diagnosis,treatment and prognosis of the patient with alveolar soft part sarcoma(ASPS)of right buccal mucosa,and to improve the clinicians’understanding of ASPS.Methods:The clinicopathologic data of a patient with ASPS of right buccal mucosa were collected;the clinical characteristics,pathological diagnosis features,differential diagnosis,treatment and prognosis were summarized,and the relevant literatures were reviewed.Results:A 46-year-old male patient was admitted to local hospital because of right buccal mucosal tumor found 3 months ago.The tumor increased slowly without pain or other clinical symptoms.The patient was diagnosed as benign tumor and underwent surgical treatment.No definite pathological diagnosis was found after surgery.In order to conform the diagnosis,the patient came to our hospital for consultation.Histologically,the neoplastic cells were characterized by aggregates of large polygonal or round mesenchymal cells with abundant eosinophilic and granular cytoplasm.The tumor showed a solid,diffuse growth pattern,without organoid or nested architecture,and tumor thrombi could be seen.The neoplastic cells were negative for CK(p)and Vimentin,and demonstrated partly positivity for SAM and Desmin,and diffuse intense nuclear positivity for TFE3.The pathological diagnosis was ASPS(solid pattern),with blood vessel invasion.The patient did not receive radiotherapy or chemotherapy after operation.There was no recurrence and metastasis after follow-up of 5 months.Conclusion:ASPS has no specific clinical characteristics and imaging features.The diagnosis of ASPS mostly depends on the histopathological and immunohistochemical examinations.Solid ASPS is more likely to be misdiagnosed.Radical resection is the main treatment for ASPS and the patients should be given regular follow-up after operation.

关 键 词：腺泡状软组织肉瘤 颊黏膜 免疫组织化学 病例报告 

分 类 号：R739.8[医药卫生—肿瘤]