牙源性钙化上皮瘤3例临床病理观察

发布时间：2018-10-14 18:21

【摘要】：目的对牙源性钙化上皮瘤的病理诊断、鉴别诊断和预后进行分析。方法用光镜观察、免疫组化、特殊染色对3例牙源性钙化上皮瘤进行临床病理分析,并复习相关文献。结果 3例牙源性钙化瘤中2例位于下颌骨内,1例位于上颌骨内。镜下肿瘤由纤维间质和多边形上皮细胞岛及团片构成。肿瘤细胞含丰富的嗜酸性胞质,细胞间界限非常清楚,有分化良好的细胞间桥;细胞核常呈多形性,巨型核常见,核分裂象罕见。在肿瘤细胞团片中央或其外周,可见嗜酸染色的、均一的透明物质,刚果红染色显示为淀粉样物,并常以同心圆的方式发生钙化。钙化是该肿瘤的特征。免疫组化:上皮细胞p63和HCK(+)。随访:1例术后6年复发,1例术后2年无复发,1例术后恢复中。结论牙源性钙化上皮瘤较少见,肿瘤有独特的病理组织学特点,可向局部侵袭性生长,需要与骨内原发或转移的鳞状细胞癌、涎腺的恶性肿瘤(包括黏液表皮样癌和腺泡细胞癌)、肾透明细胞癌转移等相鉴别。手术切除不彻底可复发,建议临床长期随访。
[Abstract]:Objective to analyze the pathological diagnosis, differential diagnosis and prognosis of odontogenic calcified epithelioma. Methods three cases of odontogenic calcified epithelioma were analyzed by light microscopy, immunohistochemistry and special staining. Results among 3 cases of odontogenic calcification, 2 cases were located in the mandible and 1 case in the maxilla. Microscopically, the tumor consists of fibrous stroma and polygonal epithelial islands and lumps. Tumor cells are rich in eosinophilic cytoplasm and have well-differentiated intercellular bridges. The nuclei are often pleomorphic, giant nuclei are common, and mitosis is rare. In the center of tumor cell mass or its periphery, acidophilic and homogeneous transparent substance can be seen. Congo red staining shows amyloid, and calcification often occurs in concentric way. Calcification is characteristic of the tumor. Immunohistochemistry: p63 and HCK (). In epithelial cells Follow up: 1 case recurred 6 years after operation, 1 case did not recur 2 years after operation, 1 case recovered. Conclusion Odontogenic calcified epithelioma is rare. It has unique histopathological features and can be locally invasive. It needs to be associated with intraosseous primary or metastatic squamous cell carcinoma. Malignant tumors of salivary gland (including mucoepidermoid carcinoma and acinar cell carcinoma) and metastasis of renal clear cell carcinoma are distinguished. Surgical resection can not be completely recurrence, clinical long-term follow-up is recommended.
【作者单位】：湖北文理学院附属襄阳市中心医院;
【分类号】：R739.8

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