乳腺颗粒细胞瘤1例报告并文献复习

目的 探讨乳腺颗粒细胞瘤(GCT)临床病理特征及诊断和鉴别诊断.方法 复习1例乳腺颗粒细胞瘤的临床病理资料进行病理形态和免疫组化观察.结果 1例GCT无特殊临床症状及体征,细胞境界清楚,胞体宽大,胞浆丰富,充满大的嗜酸性颗粒,浸润性生长,瘤细胞S-100(+),PAS(+),VIM(+),CEA(-).结论 乳腺颗粒细胞瘤少见,临床、细胞学及冰冻快速病理检查均易误诊为恶性肿瘤,应提高对此疾病的认识,减少不必要的扩大手术.     

乳腺颗粒细胞瘤病理误诊2例分析

目的 总结乳腺颗粒细胞瘤临床误诊经验教训.方法 回顾分析2例乳腺颗粒细胞瘤术前临床病理资料.结果 2例乳腺颗粒细胞瘤临床症状及体征无明显特殊性,镜下结构,细胞形态特殊,生长方式呈浸润性,免疫组化检查显示S-100、NSE(+),CEA(-).结论 乳腺颗粒细胞瘤较少见,临床、细胞学及冰冻、微波快速病理检查均易误诊为恶性肿瘤,应提高对此疾病的认识,提高对该病的术前病理诊断,减少不必要的扩大手术.     

乳腺颗粒细胞瘤1例及文献复习

目的探讨乳腺颗粒细胞瘤的临床病理特征。方法对1例乳腺颗粒细胞瘤病例进行临床病理、免疫组化观察并文献复习。结果组织学特点:瘤细胞体积大,圆形或多边形,胞浆丰富充满嗜酸性颗粒,细胞核小,免疫组化染色显示:S-100、NSE均阳性,不表达CKpan、ER、PR。结论乳腺颗粒细胞瘤是一种罕见的良性肿瘤,在冰冻切片时易与乳腺癌混淆,其诊断主要依靠组织病理学和免疫组化标记。     

膀胱副神经节瘤2例报告并文献复习

目的 探讨膀胱副神经节瘤的临床病理及免疫组化特征.方法 对2例膀胱副神经节瘤进行组织病理学观察及免疫组化分析并复习文献.结果 2例大体肿物均有完整包膜.镜下肿瘤细胞排列呈巢状及条索状,其中1例伴有鳞状细胞或腺样分化的器官样结构.细胞大小不等,细胞核圆形、椭圆形、梭形,核分裂罕见.瘤细胞巢间有丰富的大、小血窦.免疫组化瘤细胞CgA、Syn、S-100阳性,CK、CK7、HMB45、CEA阴性.结论 膀胱副神经节瘤是较罕见的肿瘤,诊断依赖于组织病理形态及免疫组化.     

乳腺颗粒细胞瘤1例报道

颗粒细胞瘤(granular cell tumor)是一种少见的软组织良性肿瘤,可以发生于任何部位,大多数位于头颈部,发生于乳腺者少见.本文报道1例乳腺颗粒细胞瘤,分析该肿瘤的临床病理特征、影像学、免疫组化特点及诊断和鉴别诊断要点,并结合文献进行讨论.     

原发性食管恶性黑色素瘤影像学及临床病理学特征

【目的】探讨食管原发性恶性黑色素瘤（PM M E ）的影像学、临床病理学特征,诊断、鉴别诊断及治疗。【方法】回顾性分析5例PM M E患者的临床资料,结合相关文献对其临床表现、影像学、组织形态和免疫组化特点及治疗和预后等进行分析。【结果】5例患者均为老年男性,平均年龄63．4岁,均表现为进食不畅,症状呈进行性加重。胃镜检查示：3例距门齿25～35 cm食管前壁及左侧壁见不规则结节状肿物及息肉样肿物,2例距门齿35～40 cm食管右侧壁及右后壁见不规则溃疡型肿物。C T检查显示：食管中、下段管腔内偏心性肿瘤,增强扫描5例肿瘤均有强化,其中1例病灶强化均匀,其余4例呈不均匀强化。肿瘤病理组织学表现：瘤细胞排列呈巢片状或条索状,细胞圆形或多角形,胞质丰富红染,胞质内见黑色素颗粒,细胞核大小不一,核居中或偏位,核仁明显,病理性核分裂象易见。免疫表型：瘤细胞弥漫表达HMB‐45、Melan A、S‐100;CK阴性,Ki‐67阳性细胞数30％～35％。【结论】食管原发性恶性黑色素瘤非常罕见,有特征性的影像学、组织学、病理学特点,有助于该肿瘤诊断。     

多形性黄色瘤型星形细胞瘤3例临床病理观察

目的 探讨多形性黄色瘤型星形细胞瘤(PXA)的临床病理学特点及CD34在其鉴别诊断中的应用价值.方法 对3例多形性黄色瘤型星形细胞瘤的临床特点、影像学表现、组织学形态及免疫组化结果进行观察,并结合文献复习讨论.结果 3例患者平均年龄23岁,2例位于顶叶,1例位于额叶.影像学上3例均位于幕上,其中1例呈囊性,囊内壁小结节明显强化;2例以结节状实性病变为主,未见强化.组织学均可见黄瘤样细胞和血管周围淋巴细胞浸润,其中2例伴梭形细胞成分,3例均未见核分裂象和血管内皮细胞增生.免疫组化示黄瘤样细胞CD68和GFAP(+),CD34弥漫(+),Syn散在(+),Ki-67增殖指数为2％ ～4％.结论 PXA是一种罕见的具有特殊影像学和临床病理特点的星形细胞肿瘤.CD34是PXA的一种敏感标记物,对于诊断PXA及与其他脑肿瘤相鉴别具有较高的应用价值.     

肾和膀胱恶性纤维组织细胞瘤(附三例报告)

目的探讨泌尿系恶性纤维组织细胞瘤的影像学表现,以提高对本病的认识。方法回顾性分析2例肾脏、1例膀胱恶性纤维组织细胞瘤的临床、病理资料和影像学表现。结果 3例(男2例、女1例)均行手术切除,2例发生于右肾,术前均诊断为肾癌,1例位于膀胱的左侧壁。术后病理和免疫组化证实为恶性纤维组织细胞瘤。结论恶性纤维组织细胞瘤术前与肾的其他恶性肿瘤(如肾癌、肉瘤)鉴别困难,确诊应依赖病理及免疫组化。     

垂体细胞瘤临床病理观察

目的 探讨垂体细胞瘤的临床病理学特点及诊断要点.方法 对2例垂体细胞瘤的临床资料、影像学、病理形态学及免疫组化结果进行分析,并结合文献探讨其诊断及鉴别诊断.结果 2例患者的头颅MRI提示鞍区占位.镜下可见短梭状双极梭形细胞成分,细胞密度较低,排列稀疏,呈纤维束状排列,细胞核圆形或伸长形,局部可见血管结构,未见核分裂.免疫组化:vimentin、S-100和GFAP均(+)、Ki-67增殖指数＜1％,NEU-N和EMA均(-).结论 垂体细胞瘤起源于成人神经垂体或漏斗,较为罕见,由梭形细胞构成,生长缓慢,需与正常漏斗组织、毛细胞星形细胞瘤、梭形嗜酸细胞瘤等进行鉴别诊断.     

乳腺血管外皮瘤/孤立性纤维性肿瘤临床病理观察

目的探讨乳腺血管外皮瘤/孤立性纤维性肿瘤(HPC/SFT)的病理学特点、诊断及鉴别诊断。方法对1例乳腺HPC/SFT进行临床病理、组织形态、免疫组化染色进行观察并复习文献。结果该病组织学特点为血管丰富,呈分支状,瘤细胞围绕血管呈放射状或弥漫排列,瘤细胞呈圆形、椭圆形和梭形,细胞界限不清。免疫组化染色vimentin、CD34、CD99和bcl-2均(+)。结论 HPC/SFT是少见的软组织肿瘤,发生在乳腺更为罕见,预后好。应根据形态学特点,结合免疫组化结果鉴别。     

喉颗粒细胞瘤

目的 讨论喉颗粒细胞瘤的组织发生、形态学特点和生物学行为。方法 报道３例喉颗粒细胞瘤并进行组织形态学、组织化学及免疫组织化学染色研究。结合文献对本病的诊断标准、鉴别要点及组织来源进行探讨。结果 这形态特点与其他软组织颗粒细胞瘤基本一致,但５０％～６０％伴有肿瘤表面鳞状上皮呈假上皮瘤样增生,免疫组化Ｓ－１００、Ｖｉｍｅｎｔｉｎ、ＣＤ６８、ＭＢＰ等在肿瘤细胞胞浆内呈阳性表达,ＰＡＳ染色中胞浆为阳性反应。结论 发生于喉部的颗粒细胞瘤为罕见肿瘤。通常为良性肿瘤,采用局发除法治疗,预后好,多数学者认为该肿瘤起源于雪旺细胞。     

Sonographic and mammographic appearances of granular cell tumors of the breast with pathological correlation

PURPOSE: To describe the sonographic and mammographic appearance of granular cell tumors (GCTs) of the breast in 6 patients with pathological correlation. METHODS: A search was conducted of the cyto-histopathological database in a single institution from 1990 to 2004 for breast lesions given the diagnosis of GCT of the breast. Six patients with GCT of the breast who underwent mammographic or sonographic examination or both before surgery were included in this study. RESULTS: The mammographic features of GCT of the breast were indeterminate in most patients, often presenting as an isodense mass with indistinct or spiculated margins. Calcifications were not a feature. The sonographic features of GCT of the breast mimicked carcinoma, including heterogeneous echotexture, indistinct margins, and hypervascularity. Hyperechogenicity was noted in 5 of 7 (71%) GCTs in this series. The cytomorphological features of GCT included sheets of large granular cells intersected by arborizing thin-walled blood vessels. The cells had round to oval nuclei, inconspicuous nucleoli, and abundant, ill-defined granular cytoplasm. CONCLUSIONS: Breast imagers should be aware that GCT of the breast is an uncommon differential in a minority of neoplasms that can be mistaken for breast cancer.     

指突状网状细胞肉瘤1例报告并文献复习

目的：探讨指突状网状细胞肉瘤（IDCS）的临床病理特点。方法：观察分析1例指突状网状细胞肉瘤光镜和电镜下的病理形态特征、免疫组化表达并进行文献复习。结果：肿瘤细胞呈弥漫分布，异型较明显；免疫组化S-100、CD68阳性；电镜下见瘤细胞表面有较多指状突起，无Birbeck颗粒。结论：IDCS是一种非常罕见的淋巴系统恶性肿瘤，诊断须依赖免疫组化和电镜。     

局限性和弥漫性腱鞘巨细胞瘤52例临床及病理

目的：探讨两种类型腱鞘巨细胞瘤（GCT）的临床病理特点。方法：对52例GGT患者的临床、病理及免疫组化进行比较。结果：局限性GCT（F－CT）40例,87．5％发生在手指,平均直径1．3cm,包膜完整,6．7％术后复发;弥漫性GCT（D－GCT）12例,全局发生在大关节,平均直径2．5cm,无包膜,呈浸润性生长,42．9％术后复发。F－GCT与D－GCT组织形态相似,但单核细胞的梭形化及滑膜样裂隙较明显,细胞异型及坏死均为2．5％;D－GCT慢性炎细胞及含铁血黄素较明显,细胞异型及坏死均为16．7％。免疫组化显示两种类型中核细胞Vim( )、68( )、PCNA( ),而多核巨细胞Vim( )、CD68（＋）、PCNA（－）。在2例D－GCT中另见散在性SMA（＋）、Des( )、S－100（＋）的大细胞。结论：F－GCT与D－GCT的生长方式和术后复发率明显不同。     

Characterization of sonographic and mammographic features of granular cell tumors of the breast and estimation of their incidence.

OBJECTIVE: The purpose of this series was to review the spectrum of sonographic and mammographic features of granular cell tumors (GCTs) of the breast and to compare their frequency relative to breast carcinoma. METHODS: Ten cases of a breast GCT diagnosed during the last 13 years were analyzed for the imaging characteristics and clinical features. Sonographic images were reviewed for location, size, echogenicity, margins, height-width ratio, and sound transmission. Mammograms were reviewed for tumor size, location, margin characteristics, spiculations, and calcifications. The frequency of GCTs was compared with that of breast carcinoma during the same study period. RESULTS: Of 10 GCT cases, 9 tumors occurred in female patients, and 1 occurred in a male patient. The mean patient age was 51.8 years, and the mean lesion size was 1.57 cm. All 7 tumors visualized on sonography were hypoechoic masses. Posterior enhancement was noted in 3 of 7 cases, and posterior shadowing was noted in 2 of 7 cases. Two of 7 did not show any posterior enhancement or shadowing. Two of 7 masses were taller than wide. Of 8 tumors visualized on mammography, 5 were spiculated, and 3 were well circumscribed. Calcifications were not visualized in any tumor. During the same period, 1482 cases of breast carcinoma were diagnosed, making the frequency of GCTs of the breast about 6.7 per thousand breast carcinomas. CONCLUSIONS: Granular cell tumors of the breast are rare neoplasms with a relative frequency of 6.7 per thousand breast carcinomas in our series, which was higher than reported in literature. Spiculations are a common imaging feature and mimic carcinoma when present.     

Concurrence of granular cell tumor and Mycobacterium tuberculosis

Granular cell tumors (GCT) are rare, usually benign neoplasms of Schwann cell origin. Since discovery in 1926, fewer than 80 cases of GCT involving the lung have been reported. This report presents a 45-year-old male who presented with symptoms consistent with chronic pancreatitis associated with night sweats, weight loss, and a chronic productive cough. Chest radiography revealed a 3 x 4 cm left upper lobe lung mass with an unremarkable right lung field. Bronchoscopy revealed mixed mucosal abnormalities in the left upper lobe and a 4-mm polypoidal lesion in the right lower lobe. Bronchial washings stained positive for acid-fast bacilli. The left upper lobe lesion biopsy showed granulomatous inflammation with caseous necrosis consistent with tuberculosis. The right lower lobe lesion was a GCT without evidence of tuberculosis. This report reviews the literature regarding GCT and presents this unusual case of granular cell tumor co-occurring with active tuberculosis.     

股骨促结缔组织增生性纤维瘤2例报告并文献复习

目的探讨股骨促结缔组织增生性纤维瘤(DF)的临床病理特征及诊断与鉴别诊断。方法对2例股骨DF进行病理形态和免疫组化观察,结合临床资料进行分析并复习相关文献。结果组织学特点:肿瘤由梭形瘤细胞和大量胶原构成,胶原纤维密集而粗大,呈波浪状或束状,瘤细胞核形态温和,肿瘤多呈浸润性生长。免疫组化:瘤细胞-βcatenin(2/2)、Vimentin(2/2),Desmin、SMA局灶(+)。结论骨DF具有较强的局部侵袭能力,切除不彻底容易复发,应手术广泛全切。联合检测-βcatenin、SMA、Vim、Desmin等标记物对骨DF诊断和鉴别诊断具有重要意义。     

肺嗜酸细胞类癌2例病理学观察

目的 探讨肺嗜酸细胞类癌的病理学特点及鉴别诊断。方法 对2例肺嗜酸细胞类癌的组织病理学、免疫组织化学及电镜结果进行观察分析。结果 2例肺嗜酸细胞类癌的组织病理学特点：瘤细胞胞质内有多量嗜酸性细颗粒。免疫组化：角蛋白、NSE、CgA、Syn呈阳性表达，S－100呈阴性表达。电镜：瘤细胞胞质内见多量神经内分泌颗粒和增多的线粒体。结论 肺嗜酸细胞类癌具独特的病理学特点，免疫组化和电镜结果有助于鉴别诊断。     

巨细胞纤维母细胞瘤误诊1例并文献复习

目的 :观察巨细胞纤维母细胞瘤病理形态及免疫组化特点 ,并探讨其鉴别诊断及组织来源。方法 :对 1例巨细胞纤维母细胞瘤进行光镜及免疫组化染色。结果 :肿瘤细胞主要由具有轻至中度异型性的梭形细胞组成 ,呈束状或波浪状排列 ,间质粘液样变及胶原化。本病主要的形态特征性为 :出现独特的不规则分布的裂隙或假血管腔 ,内衬多核巨细胞 ,免疫组化 Vimentin、CD34呈阳性表达。结论 :巨细胞纤维母细胞瘤是一种好发于儿童的中间性的软组织肿瘤 ,具有局部复发倾向 ,与成人的隆突性皮肤纤维肉瘤可能同属 CD34阳性的树突状纤维母细胞肿瘤     

肝脏滤泡树突状细胞肉瘤1例报告并文献复习

目的：探讨肝脏滤泡树突状细胞肉瘤的临床病理特征，影像学表现，诊断与鉴别诊断。方法；病例报告与文献复习。结果：CT：肝内巨大单发肿块。光镜；肿瘤细胞呈梭形及卵圆形，细胞间界限不清。免疫组化：部分肿瘤细胞CD21（＋）和CD35（＋）。结论：肝脏滤泡树突状细胞肉瘤罕见，其诊断及鉴别诊断主要依靠免疫组织化学。