神经母细胞瘤体表转移14例临床病理分析.pdfVIP

中华小儿外科杂志 2015 年 1 月第 36 卷第 1 期 Chin J Pj! diatr Surg.January 2015. Vol. 36.Nα1 17 ·肿瘤外科专题· 神经母细胞瘤体表转移 14 例临床病理分析 陈卫坚周峰珍刘敏张丽琼姜楠 E摘要】 目的分析体麦转移性神经母细胞瘤(NB)的临床、病理形态学特点、诊断与鉴别诊断 及预后。方法 回顾分析本院2005 年至2011 年间 14 例诊断为 NB 体表转移病例的临床、病理学资 料及随访资料。男 8 例，女 6 例。发病年龄 5 个月 ~6 岁 10 个月，平均发病年龄 33 个月，年龄〈 1. 5 岁3 例.1. 5~3 岁 4 例.3 岁 7 例。肿瘤原发部位z 后腹膜 8 例，肾上腺 4 例，盆腔 1 例，纵踊 1 例。体表转移部位2 体表淋巴结转移共 11 例(78.6%) .其中颈部淋巴结 9 例、腹股沟淋巴结 2 例J; 肩背部皮下 1 例，臀部皮下 1 例;阴囊 1 例。组织学分型:未分化型3 例，分化差型9 例，分化型 2 例。 未分化型与分化差型共 12 例(85.7%) 。结果 14 例 NB体表转移患儿，随访时间平均 13 个月 .9 例 (64.3%)放弃治疗后死亡，3 例化疗后死亡，2 例(14.3%)3 年元瘤生存。免疫组化染色结果:14 例 NB体表转移的肿瘤细胞Syn 与 CgA 均弥漫性强阳性表达.NSE 除 1 例未分化型 NB外其余均阳性 表达。肿瘤细胞对Vim、 LCA、 CD99、 DES、S-100 等抗体均阴性表达。肿瘤组织中神经黯膜细胞阳性 表达S-100。结论 NB转移至体表多处部位以淋巴结转移最多见，以未分化型及分化差型为主要类 型，预后较差。免疫组化有助于诊断与鉴别诊断。 E关键词】 神经母细胞瘤;转移;免疫组化 Clinicopathologic featw喧嚣 。，f body s町fa~ metastasis of neuroblastoma Chen Weijian , Zhou Zhengzhen , Liu min , Zhang Liqiong , ] iang Nan. Deρartment of Pathology , Children s Hospital of Hunan , Changsha 410007 , China Corresponding author: Chen Weijian .Email: 2209962586 ( [Abstract] Objective To analyze the clinicopathologic features , diagnosis , differential diagnosis and prognosis of body surface metastatic neuroblastorna (NB). Methods A total of 14 cases with a preliminary diagnosis of body surface metastatic neuroblastoma at our hospital from 2005 to 2011 were collected. And their clinicopathologic findings , immunohistochemical results and fo lIow-up data were recorded and analyzed. ResuJts There were 8 males and 6 females with an average age of 33 (5-82) months. And 7 cases (50%) were above 3 years. The metastatic sites were lymph node (n = 11) • neck (η= 9) and inguinal (n = 2). The subcutaneous metastasis was located in shoulder (n = 1) , gluteal region (n = 1) and scrotum (n = 1). Histological type