文章摘要

10例软组织颗粒细胞瘤的临床病理特征

作者: 1常 艳华, 2陈 勇, 1陈 文凯, 1梁 加贝
1 南京医科大学附属无锡人民医院病理科,江苏 无锡 214023
2 南京医科大学附属无锡人民医院肾内科,江苏 无锡 214023
通讯: 常 艳华 Email: yh-chang1@163.com
DOI: 10.3978/j.issn.2095-6959.2019.01.006

摘要

目的:分析软组织颗粒细胞瘤(granular cell tumor,GCT)的各项临床特点、形态学特点、免疫表型、诊断、鉴别诊断及预后,加深对该病的认识,提高诊断的准确性。方法:回顾性分析10例GCT的临床特点、形态学特点及免疫表型,并复习相关文献。结果:10例GCT组织学形态相似, 镜下示肿瘤细胞较大,呈多边形、圆形或卵圆形,胞核较小,胞质内富含嗜酸性颗粒。肿瘤细胞多侵及周围组织,有些瘤细胞围绕神经小束生长。免疫组织化学检查示肿瘤细胞表达S-100蛋白和神经元特异性烯醇化酶(neuron-specific enolase,NSE),大部分表达CD68,不表达细胞角蛋白(AE1/AE3)、结蛋白(Desmin)、平滑肌肌动蛋白(smooth muscle actin,SMA)、特异性肌动蛋白(muscle-specific actin,MSA)、黑色素A(Melan-A)和HMB45,Ki-67的增殖指数较低,大部分<3%。 结论:GCT是一种少见的软组织肿瘤,术前不易诊断,确诊主要靠病理诊断。手术是其主要的治疗方法,良性者预后好,极少数病例为恶性,预后差。
关键词: 软组织肿瘤;颗粒细胞瘤;临床病理特征;鉴别诊断

Clinicopathologic features of 10 cases of soft tissue granular cell tumor

Authors: 1CHANG Yanhua, 2CHEN Yong, 1CHEN Wenkai, 1LIANG Jiabei
1 Department of Pathology, Wuxi People’s Hospital, Affiliated to Nanjing Medical University, Wuxi Jiangsu 214023, China
2 Department of Nephrology, Wuxi People’s Hospital, Affiliated to Nanjing Medical University, Wuxi Jiangsu 214023, China

CorrespondingAuthor:CHANG Yanhua Email: yh-chang1@163.com

Abstract

Objective: To further understand granular cell tumor (GCT) and to improve diagnostic accuracy through analyzing the clinicopathological features, the immune phenotype, diagnosis, differential diagnosis and prognosis of GCT. Methods: The clinical features, morphologic changes and immune phenotypes of 10 cases of GCT were retrospectively analyzed and relevant literatures were reviewed. Results: Ten GCT cases had similar histologic morphology. The tumor cells were large, polygonal, round or oval, with small nuclei and abundant cytoplasm that was rich in eosinophilic particles. The tumor cells invaded the surrounding tissues, and some of them grew peripherally around the small nerve bundle. The immunohistochemical analysis showed that the tumor cells expressed S-100 protein and neuron-specific enolase (NSE), most of which expressed CD68, but did not express cytokeratin (AE1/AE3), Desmin, smooth muscle actin (SMA), muscle specific actin (MSA), Melan-A or HMB45. The Ki-67 proliferation index was low, usually below 3%. Conclusion: GCT is a rare soft tissue tumor, whose preoperative diagnose is difficult. Surgery is the main treatment. Benign cases show good prognosis. Very few cases are malignant with poor prognosis.
Keywords: soft tissue neoplasms; granular cell tumor; clinicopathological features; differential diagnosis