头颈部炎性肌纤维母细胞瘤

目的 炎性肌纤维母细胞瘤（inflammatory myofibroblastic tumor,IMT）是一种可发生于头颈部的罕见肿瘤,本文就其临床表现、病理组织学特征、治疗及预后进行探讨.方法 回顾性分析4例头颈部IMT患者的临床资料,并进行光镜检查及免疫组化染色.结果 IMT肿瘤组织学由具有平滑肌细胞和纤维母细胞特征的梭形肿瘤细胞、大量慢性炎性细胞及黏液血管样背景构成.免疫组化：平滑肌特异性肌动蛋白（smooth muscle actiVe,SMACTIN）、波形蛋白（Vimentin）呈强阳性表达.术后随访9～21月,2例声带IMT无复发,1例上颌窦IMT无复发,另1例上颌窦鼻腔IMT术后4个月再次复发.结论 IMT是兼有纤维母细胞及平滑肌细胞特征的肿瘤,具有局部复发倾向.治疗以根治性手术切除为主,术后放疗、化疗效果不确定.鼻窦I MT极易复发,具有局部浸润行为,手术切除须彻底.

Inflammatory myofibroblastic tumor of the head and neck

OBJECTIVE Inflammatory myofibroblastic tumor(IMT) is a rare lesion of unknown etiology which was first described in the lung. The clinical and pathologic characteristics,treatment, prognosis of IMT in head and neck were discussed. METHODS The clinical data of 4 cases of IMT were analyzed retrospectively. The specimens of the 4 cases were prepared for immunohistochemical staining and light microscopy. RESULTS The patients included 3 males and 1 female. Their age ranged from 32 to 58 years. The tumors located at the true vocal cord in 2 cases, at the nasal cavity and maxillary sinus in 1 case, at the maxillary sinus in 1 case. Histological examination was found that the tumors consisted of spindle cells,chronic inflammatory cells and myxoid background with delicate vasculature. Immunohistochemical staining demonstrated that the SMActin and Vimentin were expressed positively in the tumor. The patients were followed up for 9 to 21 months after operation. Three patients were alive with no evidence of diseases, one patients recurred at 4 months after operation and were alive with IMT. CONCLUSION IMT is a true neoplasm with a potential of local recurrence. The main treatment of IMT is to resect the lesions thoroughly.