鼻腔鼻窦畸胎癌肉瘤临床病理学观察及分析

发布时间：2018-09-05 14:17

【摘要】：目的:探讨鼻腔鼻窦畸胎癌肉瘤(SNTCS)的临床病理学特征、免疫学表型、诊断及鉴别诊断。方法:分析1例SNTCS的临床表现,对标本进行病理学和免疫组织化学(SP法)染色观察并复习相关文献。结果:肿瘤组织由3个胚层构成,有外胚层的成熟和未成熟的鳞状细胞巢、神经上皮细胞团及嗅母细胞样细胞,中胚层的肉瘤样成分和骨组织,以及内胚层的呼吸道上皮及腺管样结构,部分为腺癌;其中幼稚的透明细胞鳞状细胞巢非常具有特征性。此外,尚可见弥漫大片胞质丰富的淡染区及胞质较少的深染区,二者疏密有间。免疫组织化学染色显示不同的胚层对应相应的免疫标记,鳞状上皮、腺上皮和呼吸道上皮CK、EMA等阳性,神经上皮细胞团及嗅母细胞样细胞S-100、NSE、Syn等阳性,肉瘤样区Vim阳性,淡染区Vim、CD99及CK等不同程度阳性,深染区NSE和GFAP阳性。结论:SNTCS是具有畸胎瘤和癌肉瘤特征的罕见恶性肿瘤,具有特征性的组织病理学和免疫组织化学染色特点,应多取材多切片,以免误诊和漏诊。
[Abstract]:Objective: to investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of teratosarcoma of nasal cavity and paranasal sinuses (SNTCS). Methods: the clinical manifestations of one case of SNTCS were analyzed. The pathological and immunohistochemical (SP) staining methods were used to observe and review the relevant literature. Results: the tumor tissue was composed of three layers, including mature and immature squamous cell nests, neuroepithelial cell clusters and olfactory blast-like cells, sarcomatoid components and bone tissue of mesoderm. The respiratory epithelium and glandular tubules of the endoderm are partly adenocarcinoma, and the nests of the squamous cells of the puerile transparent cells are very characteristic. In addition, we can see a large area of diffuse cytoplasm rich light stained area and less cytoplasm deep stained area. Immunohistochemical staining showed that the corresponding immunological markers were found in different embryonic layers, such as CK,EMA positive in squamous epithelium, glandular epithelium and respiratory tract epithelium, S-100NSE-Syn positive in neuroepithelial cell clusters and olfactory mother cell-like cells, and Vim positive in sarcomatoid region. Vim,CD99 and CK were positive in light stained area and NSE and GFAP in deep stained area. Conclusion SNTCS is a rare malignant tumor with the characteristics of teratoma and carcinosarcoma. It has the characteristics of histopathology and immunohistochemical staining. We should take more materials and sections to avoid misdiagnosis and missed diagnosis.
【作者单位】：内蒙古自治区人民医院病理科;
【分类号】：R739.62

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