喉恶性纤维组织细胞瘤临床病理观察_临床医学论文.docVIP

喉恶性纤维组织细胞瘤临床病理观察_临床医学论文 喉恶性纤维组织细胞瘤临床病理观察_临床医学论文 【关键词】 喉恶 　　摘要：目的：观察喉恶性纤维组织细胞瘤病理形态，进一步探讨其组织起源、病理学诊断及鉴别诊断。方法：对4例喉恶性纤维组织细胞瘤的临床病理学资料进行回顾性分析总结。 结果：①4例喉恶性纤维组织细胞瘤患者，男3例，女1例，年龄51～75岁，平均58岁。②喉恶性纤维组织细胞瘤病理形态主要表现为车辐状排列的纤维母细胞、混杂有组织细胞等其他多种细胞成分，细胞有明显的异型性。③喉恶性纤维组织细胞瘤常规组织学与癌肉瘤、多形性横纹肌肉瘤、粘液型脂肪肉瘤、恶性神经鞘瘤、粘液瘤有时易混淆，免疫组织化学有助于明确诊断。结论：①喉恶性纤维组织细胞瘤可能起源于原始间质干细胞并具有组织细胞、成纤维细胞形态学特征。② 喉恶性纤维组织细胞瘤容易发生误诊，免疫组化检查有助于鉴别诊断。③喉恶性纤维组织细胞瘤具有高度浸润性，易复发。治疗上采取根治性手术切除并联合放疗及化疗的综合治疗措施。 　　关键词：喉肿瘤；恶性纤维组织细胞瘤；临床病理；免疫组织化学 　　Clinicopathological Observation of Malignant Fibrous Histiocytoma of the Larynx 　 Abstract: Objective: To investigate the source, clinicopathological feature and differential diagnosis of malignant fibrous histiocytomas (MFH) of larynx. Methods: The clinical and pathological data of 4 cases with MFH of larynx were retrospectively analysed .Results： ①All the 4 cases with MFH of larynx were adults (the age ranged from 51 to 75 years ;average 58 years);3 were men and 1 woman . ②The pathology of the MFH of larynx was storiform fibroblasts mixed with histiocyte ,giant cell and other cells . All cells displayed varied anaplasia . ③Some of the laryngeal MFH were difficult to be differentiated from carcinosarcoma, pleomorphic rhabdomyosarcoma , myxoid liposarcoma ,malignant neurilemmoma and myxoma without immunohistochemical aids .Conclusion: ①MFH of larynx may be derived from mesenchymal cell , expressing histocytic and fibroblastic marker .②The diagnosis of MFH of larynx was sometimes difficult and immunohistochemistry could be helpful .③Laryngeal MFH has an aggressive biological behaviour . Radical resection with accessorial radiotherapy is a most popular treatment . 　　Key words: Laryngeal neoplasms ; Malignant fibrous histiocytoma ;Clinical pathology; Immunohistochemistry 　　恶性纤维组织细胞瘤（malignant fibrous histiocytoma, MFH）是起源于间叶组织的恶性肿瘤，1964年由0’Brien［1］等首次提出，其组织来源目前尚不明确。肿瘤较多发生于四肢、躯干、腹膜后等深部软组织，头颈部较少见，近年来渐见增加。本文观察了4例喉恶性纤维组织细胞瘤的病理形态、免疫组化表达，结合文献讨论其组织来源、诊断和鉴别诊断。 　　1 材料与方法 　　收集本院1980年1月至2004年10月间喉恶性纤维组织细胞瘤共4例。所有标本均