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目的 对原发性中耳类癌复发进行病理分析。方法 将活检标本作组织学(HE 染色)、组织化学(奥辛蓝、PAS、嗜银染色)、免疫组化染色(SP 法)检查。结果 组织学,前后两次活检种瘤形态一致,主要由实体小梁状及腺管状两种结构组成,瘤细胞异形性小,未见核分裂,但可见肿瘤呈浸润性生长。组织化学,奥辛蓝(AB)、过碘酸雪夫氏反应(PAS)染色阴性,嗜银染色胞浆内可见嗜银颗粒。免疫组化,突触素(Syn)、神经特异性烯醇化酶(NSE)、细胞角蛋白(CK)弥漫阳性,嗜铬蛋白(CgA)灶性阳性,溶菌酶(Lyz)阴性。结论 原发性中耳炎癌的病理诊断必须结合组织化学、免疫组化或电镜检查才具有诊断价值,同时要与中耳腺瘤和中耳副节瘤等肿瘤鉴别。
Objective To analyze the pathology of primary middle ear carcinoid recurrence. Methods Biopsy specimens were examined histologically (HE staining), histochemistry (AO Xin blue, PAS, silver staining) and immunohistochemical staining (SP method). Results The histology was consistent with the morphological features of the two biopsies. The tumor mainly consisted of both trabecular-like and glandular tubular structures with small heterotypic tumor cells and no nuclear fission. However, the tumors showed invasive growth. Histochemistry, oxin blue (AB), periodic acid Schiff’s reaction (PAS) staining negative, silver staining of argyrophilic cytoplasm silver particles can be seen. Immunohistochemistry showed that synaptophysin (Syn), neuron specific enolase (NSE), cytokeratin (CK) were diffusely positive, CgA positive was foci, and Lyz was negative. Conclusion The pathological diagnosis of primary otitis media should be combined with histochemistry, immunohistochemistry or electron microscopic examination before it has diagnostic value, and at the same time with the diagnosis of middle ear adenoma and the tumor of the appendages of the middle ear.