Neurothekeoma 4例临床病理分析  

Neurothekeoma:a clinical and pathological analysis of four cases

作　　者：尹霞 程君[2] 杨洪燕 徐德 YIN Xia;CHENG Jun;YANG Hong-yan;XU De(Department of Pathology,the Affiliated Hospital of Panzhihua University,Panzhihua 617000,China;Department of Basic Medicine,Panzhihua University Medical College,Panzhihua 617000,China)

机构地区：[1]攀枝花学院附属医院病理科,四川攀枝花617000 [2]攀枝花学院医学院基础教研室,四川攀枝花617000

出　　处：《诊断病理学杂志》2022年第12期1144-1147,1151,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨Neurothekeoma(NTK)的临床病理学特征、诊断及鉴别诊断。方法收集4例NTK,回顾性分析其临床特征、组织形态学、免疫表型及预后,并复习相关文献。结果患者男性2例,女性2例,年龄16~27岁(平均19.5岁)。发病部位:肩部2例,枕部1例,胸壁1例。肿瘤最大径1.0~1.5 cm(平均1.3 cm)。就诊时均表现为皮肤缓慢生长的无痛性结节。病理组织学显示低倍镜下肿瘤细胞在皮肤真皮层内呈结节状或束状排列,2例累及皮下组织。高倍镜下肿瘤细胞由圆形或卵圆形的上皮样、单核组织细胞样细胞和梭形细胞组成。其中1例细胞密度增加伴轻-中度非典型性,核分裂象3~4个/10HPF。3例可见散在分布的破骨样多核巨细胞。1例部分区域间质黏液变性。免疫组化染色显示肿瘤细胞弥漫性表达Vimentin、CD63(NKI-C3)、CD10、D2-40,不同程度表达MITF、CD68、SMA,Ki-67增殖指数1%~10%。4例术后随访时间16~60个月(平均32个月),均无复发证据。结论NTK是一种极为罕见的良性软组织肿瘤。形态学特征和免疫表型特殊,需要与多种良恶性间叶组织肿瘤鉴别,形态学观察及免疫组化染色可鉴别。Objective To explore the clinicopathological characteristics,diagnosis and differential diagnosis of neurothekeoma(NTK).Methods Four cases of neurothekeoma were collected.The clinical feathers,histomorphology,immunohistochemistry and prognosis were analyzed and the relevant literature was reviewed.Results Patients consisted of 2 men and 2 women with ages ranging from 16 years to 27 years(mean 19.5 years).Locations included the shoulder(two cases),occipitalia(one case)and chest wall(one case).The tumors measured in maximum diameter from 1.0 cm to 1.5 cm(mean 1.3 cm).All patients presented skin painless nodules with slow growth.Histopathology showed the tumor cells were arranged in nodular or fascicular shape in the dermis;hypodermis was involved in two cases.At the high power field,the tumor cells were composed of round to ovoid epithelioid or histiocytoid cells and spindle cells.The increase of cellular density was noted with mild to moderate atypia,and mitotic activity ranged from 3 to 4/10 HPF in one case.Scattered osteoclast like giant cells were seen in three cases.Myxoid degeneration in the stroma presented in some areas of one case.Immunohistochemical study showed that the tumor cells in all cases were diffuse positive for vimentin,CD63(NKI-C3),CD10 and D2-40,and expressed microphthalmia transcription factor,SMA and CD68 in varying degrees;Ki-67 proliferative index was 1-10%.Follow-up information(range:16 to 60 months,mean:32 months)showed that no evidence of local recurrence was identified in four cases.Conclusion Neurothekeoma is an extremely rare benign tissue neoplasm.It has relatively distinctive morphologic,immunohistochemical characteristics and needs to be distinguished from other benign or malignant mesenchymal tumors.Careful attentions to its characteristic histomorphology with the judicious use of immunochemistry can help to distinguish this tumor from its many mimickers.

关 键 词：NEUROTHEKEOMA 免疫组化 诊断 鉴别 

分 类 号：R738.6[医药卫生—肿瘤]