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目的探讨颗粒细胞瘤(GCT)的临床病理特征,以提高对该肿瘤的认知和诊断水平。方法应用常规病理学技术、免疫组化Polink-2HRP染色系统对43例软组织颗粒细胞瘤进行石蜡切片、HE及免疫组化染色分析,其中15例结合术中快速冷冻切片形态。依据WHO(第4版)软组织肿瘤分类诊断标准对其病理特征进行综合分析。结果 43例GCT中38例光镜下肿瘤细胞为多边形,呈巢片状排列,细胞间为胶原纤维束,胞核小、圆或卵圆形,胞质内见嗜伊红颗粒;5例细胞呈梭形,丰富密集。肿瘤与周围组织无明显边界;免疫组化:S-100、CD56、Syn、NSE、vimentin及CD68(+),CK、GFAP、desmin及Melan A(-);术中快速冷冻切片会诊9例GCT、1例误诊为恶性、5例延迟;常规病理诊断:40例GCT、3例非典型GCT。结论 GCT是较少见的外周神经组织肿瘤,准确及时的病理诊断,是保证临床治疗效果的关键。
Objective To investigate the clinical and pathological features of granulosa cell tumor (GCT) in order to improve the cognition and diagnosis of this tumor. Methods 43 cases of soft tissue granulosa cell tumor were analyzed by routine pathology and immunohistochemical Polink-2HRP staining system. HE and immunohistochemical staining were performed in 43 cases. Fifteen cases were combined with rapid frozen sections. According to WHO (4th edition) classification of soft tissue tumor diagnostic criteria for its pathological features were analyzed. Results In 43 cases of GCT, the tumor cells were polygonal in 38 cases under the light microscope. The tumor cells arranged in a nesting pattern with collagen fiber bundles. The nuclei were small, round or oval, and the eosinophilic granules were seen in the cytoplasm. Five cases of cells Fusiform, rich and dense. There was no obvious border between the tumor and the surrounding tissues. Immunohistochemistry: S-100, CD56, Syn, NSE, vimentin and CD68 (+), CK, GFAP, desmin and Melan A , 1 case was misdiagnosed as malignant and 5 cases were delayed. The routine pathological diagnosis was 40 cases of GCT and 3 cases of atypical GCT. Conclusion GCT is a rare peripheral nerve tissue tumor, accurate and timely pathological diagnosis, is the key to ensure the effectiveness of clinical treatment.