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目的探讨颌骨中心性透明细胞变异型黏液表皮样癌临床病理特点。方法报道1例中心性透明细胞变异型黏液表皮样癌,回顾分析其临床、影像学、病理组织学特点,探讨其诊断与鉴别诊断。结果患者男性,27岁,3年前发现左侧牙龈出现肿胀,进行左上颌窦囊肿手术,术后病理符合囊肿改变。1月前发现左鼻反复流脓性鼻涕、鼻塞,伴有少量血丝,异味明显。CT示:左侧上颌骨、硬腭占位。术中冷冻:倾向为成釉细胞瘤(滤泡型)。术后诊断:黏液表皮样癌(透明细胞型,中分化)。结论发生在上颌骨的透明细胞变异型黏液表皮样癌十分罕见,病理诊断尤其是术中冷冻极易误诊。确诊有赖于广泛取材、HE、免疫组化及特殊染色的综合判断。
Objective To investigate the clinicopathological features of central clear cell variant mucoepidermoid carcinoma of the jaw. Methods A case of central clear cell variant mucoepidermoid carcinoma was reported. The clinical, imaging and histopathological features were retrospectively analyzed, and its diagnosis and differential diagnosis were discussed. Results Male, 27 years old, three years ago, the left gum appeared swollen, left maxillary sinus cyst surgery, postoperative pathological changes consistent with cysts. 1 month ago found that left nasal purulent nasal discharge repeated, nasal congestion, accompanied by a small amount of bloodshot eyes, the smell was obvious. CT shows: the left maxilla, hard palate footprint. Intraoperative freezing: the tendency of ameloblastoma (follicular type). Postoperative diagnosis: mucoepidermoid carcinoma (clear cell type, moderately differentiated). Conclusion The clear cell variant mucoepidermoid carcinoma in the maxilla is very rare. Pathological diagnosis, especially intraoperative freezing, can be easily misdiagnosed. Diagnosis depends on a wide range of materials, HE, immunohistochemistry and special staining comprehensive judgment.