颌骨粘液纤维瘤7例临床病理分析  

Myxoifibroma of jaw bone:clinico-pathological analysis of 7 cases

作　　者：刘伙莲 卞丽娟 LIU Huo-lian;BIAN Li-juan(Department of Pathology,Sun Yat-Sen Memorial Hospital,Guangzhou,510120,China)

机构地区：[1]中山大学孙逸仙纪念医院病理科,广州510120

出　　处：《岭南现代临床外科》2022年第6期573-577,共5页Lingnan Modern Clinics in Surgery

摘　　要：目的 探讨颌骨粘液纤维瘤的临床病理特征及诊断要点。方法 我们收集了中山大学孙逸仙纪念医院病理科2018年7月到2022年3月期间手术送检的7例颌骨粘液纤维瘤病例,分析患者临床资料、影像检查、形态学、免疫组化结果及治疗方案。结果 7例颌骨粘液纤维瘤患者中男性3例,女性4例,年龄5~50岁,中位年龄36岁,平均年龄29.286±18.382岁。所有患者均行手术治疗。影像学及镜下均见骨质破坏,肿瘤呈疏松细丝网状结构,基质粘液水肿样,肿瘤细胞少而散在分布,细胞梭形或星芒状,核卵圆形,核分裂象罕见。肿瘤细胞一致性表达Vimentin(4/4),部分病例表达Actin(2/5),Desmin、S-100、CD34、β-catenin均阴性,Ki67阳性指数2%~5%。结论 颌骨粘液纤维瘤是罕见的良性牙源性肿瘤,但有局部侵袭性,有较高复发率,需要随诊。术前影像学容易和其他颌骨的肿瘤混淆,诊断需要组织病理和免疫组织化学来确诊。手术切除是目前主要的治疗方案。Objective To investigate the clinicopathological features and diagnosis of myxoifibroma of jaw bone.Methods We collected 7 cases of maxillary myxoifibroma from July 2018 to March 2022 in the Department of Pathology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University. The clinical data,imaging,morphology,immunohistochemical results and treatments of the patients were analyzed.Results There were 3 males and 4 females in 7 cases of maxillary myxoifibroma,aged from 5 to 50 years old,with a median age of 36 years and an average age of 29.286±18.382 years. All patients underwent surgical treatment. Both imaging and microscopy showed bone destruction. The tumor showed a loose mesh structure,matrix myxedema. Spindle or star-axed tumor cells were few and scattered,with oval nuclei and rare nuclear mitosis. Vimentin was consistently expressed in tumor cells(4/4)and Actin was expressed in some cases(2/5),while Desmin,S-100,CD34 and β-catenin were totally negative. Ki67 positive index was 2% ~ 5%.Conclusion Maxillary myxoifibroma is a rare and benign otogenic tumor,but it is locally invasive and has a high recurrence rate,requiring follow-up. Preoperative imaging is tend to be confused with other jaw tumors,and histopathological and immunohistochemical inspections are required to confirm the diagnosis. Surgical excision is the main treatment method at present.

关 键 词：牙源性肿瘤 牙源性粘液纤维瘤 牙源性粘液瘤 诊断 

分 类 号：R739.8[医药卫生—肿瘤]