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目的探讨Rosai-Dorfman病的临床病理特征。方法对1例术前影像学诊断为喉恶性肿瘤病例,复习临床病史和影像学资料,行组织学检查、特殊染色(PAS、Giemsa和Warthin-Starryy银染色)和免疫组化标记(S-100、CD68、lyzosyme、SMA、p63、CD30、CD1a和desmin)并复习文献。结果患者为老年女性。CT示喉咽腔左1/2部软组织增厚影,局部可见隆起,病变累及左侧声门上区、厌前间隙、左侧真声带及前联合,直至环状软骨下约6.5 mm。组织学显示喉黏膜及黏膜下层大量浆细胞、淋巴细胞及组织细胞弥漫浸润,且累及周围横纹肌组织,伴纤维组织大量增生,同时组织细胞内可见吞噬的淋巴细胞。免疫组化显示组织细胞S-100强(+),CD68和lyzosyme(+);其余染色及标记均为阴性。结论喉结外Rosai-Dorfman病的病理诊断需与朗格汉斯细胞组织细胞增生症等鉴别,免疫组化染色寻找S-100蛋白阳性的组织细胞及其胞质内淋巴细胞的伸入运动是有效的鉴别方法。
Objective To investigate the clinicopathological features of Rosai-Dorfman’s disease. Methods One case of laryngeal malignant tumor diagnosed by preoperative imaging was reviewed. The clinical history and imaging data were reviewed. The histological examination, special staining (PAS, Giemsa and Warthin - Starryy silver staining) and immunohistochemical staining (S - 100 , CD68, lyzosyme, SMA, p63, CD30, CD1a and desmin) and reviewed the literature. Results The patients were elderly women. CT showed throat pharynx left 1/2 thickening of soft tissue shadow, the local visible uplift, lesion involving the left supraglottic area, anorexia gap, the left true vocal cord and anterior commissure, until the annular subclavian about 6.5 mm. Histology showed a large number of laryngeal mucosa and submucosa, a large number of plasma cells, lymphocytes and tissue cells diffuse infiltration, and involving the surrounding striated muscle tissue, with a large number of fibrous tissue hyperplasia, while tissue cells can be seen phagocytic lymphocytes. Immunohistochemistry showed strong S-100 (+), CD68, and lyzosyme (+) in the tissue cells; the remaining staining and labeling were negative. Conclusions Pathological diagnosis of laryngeal and extracapsular Rosai-Dorfman’s disease needs to be distinguished from Langerhans cell histiocytosis. Immunohistochemical staining for S-100 protein-positive tissue cells and intracytoplasmic lymphocytes is effective The identification method.