炎症肌纤维母细胞肿瘤inflammatory-第三军医大学学报.docVIP

鼻咽部炎性肌纤维母细胞肿瘤1例及文献复习 龚晓瑾，木哈拜提·玉苏甫，曲利民 （新疆医科大学第二附属医院病理科，新疆乌鲁木齐830028） 【摘要】目的 探讨鼻咽部炎性肌纤维母细胞肿瘤的临床表现和免疫表型特点。方法 对1例发生在鼻咽部的炎症性肌纤维母细胞肿瘤进行光镜观察和免疫组织化学标记。结果 镜下示鼻咽部粘膜下大量增生的呈束状生长的肿瘤性梭形细胞、及多角形细胞，可见少量散在神经节样细胞及灶状或片状肿瘤性坏死，炎细胞相对少见。免疫表型，肿瘤细胞胞质Vimentin及SMA呈弥漫强阳性。此例肿瘤呈侵袭性生长过程。结论 发生于鼻咽部的炎性肌纤维母细胞肿瘤形态缺乏典型性，加之生长部位隐蔽，手术及活检困难，不易确诊，并且预后不良。 【关键词】鼻咽部；炎性肌纤维母细胞肿瘤；临床病理学 A case report and literature review of Nasopharyngeal Inflammatory myofibroblastic tumor Gong Xiao-jin,Muhabaiti, Qu Li-ming (Department of Pathology , Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830028,China) Abstract：Objective To investigate the nasopharynx Inflammatory myofibroblastic tumor clinical and immunological phenotype characteristics. Methods One cases occurred in the nasopharynx of inflammatory myofibroblastic tumor observed by light microscopy and immunohistochemical markers. Results Show the nasopharynx endoscopic mucosal hyperplasia was under massive fascicular spindle of the growth of tumor cells, and polygonal cells, we can see that a small amount of powder in the ganglion cells and tumor foci, or in patchy necrosis, inflammatory cells relatively rare. Immune phenotype, and the tumor cell cytoplasm Vimentin,SMA showed diffuse strong positive. The cases were invasive tumor growth process. Conclusion Occurred in the nasopharynx Inflammatory myofibroblastic tumor morphology lack of typicality, and the location of hidden, surgical and biopsy difficult and not easilydiagnosed, and poor prognosis. Key words: nasopharynx; Inflammatory myofibroblastic tumor；clinical pathology 炎性肌纤维母细胞肿瘤（inflammatory myofibroblastic tumor IMT）好发于肺、大网膜和肠系膜，鼻咽部罕见。由于鼻咽部的IMT形态多样，结构复杂，加之肿瘤部位隐蔽和组织取材局限性，不易确诊，直接影响到患者的治疗和预后。本文描述1例鼻咽部IMT 的病理形态，免疫组织化学特点，并结合文献探讨其临床病理特征和诊断。 材料和方法 1.临床材料：患者男性，22岁。患者2个月前诊断左侧中耳炎，在当地诊所给予抗炎治疗，效果不佳，1个月后出现左侧头面部持续性疼痛伴左耳听力下降，夜间疼痛加重，电测听及声导抗检查为左耳传导性耳聋，呈B型鼓室图，对症治疗无效。CT扫描见：左侧咽旁间隙见一不规则肿块影，无明显边界，大小约30×20mm，临近组织受压，病变与周围组织分界不清，颅底骨质明显破坏（图1、2）。鼻内窥镜检查示：左鼻咽部膨隆，表面光滑。两周后CT显示肿瘤生长较快较前范围明显增大。取活检行病理检查。 2.方法：活检标本经10％福尔马林液固定，石