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目的:探讨牙龈低度恶性肌纤维母细胞肉瘤的临床病理特征。方法:对2例发生于14岁和16岁病人的低度恶性肌纤维母细胞肉瘤的临床病理特点进行研究,其中包括肿瘤的生长方式、细胞密度、核异型性和核分裂象。对石蜡包埋组织进行免疫组织化学检测和电镜观察。结果:大体观察,肿瘤大小为2.5～3.0 cm,呈结节状生长,边界不清,切面实性灰白或灰褐色。光镜下肿瘤细胞为梭形,呈束状排列;胞质丰富,呈嗜酸性;胞核两端尖细呈波浪状,可见小核仁。电镜下瘤细胞具有肌纤维母细胞的超微结构特点。免疫组织化学检测显示瘤细胞表达平滑肌肌动蛋白、肌动蛋白结合蛋白和纤维连接蛋白。两患者均作了肿瘤切除,术后11至15个月肿瘤局部复发。结论:牙龈低度恶性肌纤维母细胞肉瘤呈浸润性生长,瘤细胞形态温和,术后复发率高。
Objective: To investigate the clinicopathological features of low grade gingival myofibroblastic sarcoma. METHODS: Two patients with low-grade myofibroblastic sarcoma, aged 14 years and 16 years, were studied for their clinicopathological features, including tumor growth pattern, cell density, nuclear atypia and mitotic figures. Paraffin embedded tissues were examined by immunohistochemistry and electron microscopy. Results: As a general observation, the tumor size was 2.5-3.0 cm and showed nodular growth with unclear boundary and gray or brownish-brown section. Under light microscope, the tumor cells were fusiform and arranged in a bundle; the cytoplasm was rich and eosinophilic; the tip of the nucleus showed wavy shape with small nucleoli. Under the electron microscope, the tumor cells have the ultrastructural features of myofibroblasts. Immunohistochemistry showed that tumor cells expressed smooth muscle actin, actin-binding protein and fibronectin. Both patients underwent resection of the tumor, local recurrence of the tumor 11 to 15 months after surgery. Conclusion: Low gingival malignant myofibroblastic sarcoma showed invasive growth with mild tumor cells and high postoperative recurrence rate.