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目的 探讨喉部癌肉瘤的诊断和鉴别诊断。方法 选取喉部鳞癌10例,梭形细胞癌3例,癌肉瘤2例,恶性淋巴瘤6例,恶性纤维组织细胞瘤4例,横纹肌肉瘤4例,共29例,全部进行病理光镜复查及免疫组化检测。结果 癌肉瘤呈多次病理活检,报告前后不一,全喉标本肿瘤表面光滑,基底部小,切面组织细嫩,光镜显示肿瘤同时具有恶性的上皮成分和恶性的间叶成分。从形态上看癌肉瘤与梭形细胞癌最易混淆,免疫组化检测,恶性的上皮成分CK(+),VIM(-),而恶性的间叶成分则CK(-),VIM(+),梭形细胞癌肿瘤区域CK(+),VIM(-)。结论 喉部癌肉瘤的诊断应慎重,需有典型的病理形态及可靠的免疫组化检测手段和严格的评判标准
Objective To investigate the diagnosis and differential diagnosis of laryngeal carcinosarcoma. Methods Ten cases of laryngeal squamous cell carcinoma, 3 cases of spindle cell carcinoma, 2 cases of carcinosarcoma, 6 cases of malignant lymphoma, 4 cases of malignant fibrous histiocytoma and 4 cases of rhabdomyosarcoma were selected, all of them were examined by pathological light microscopy And immunohistochemistry. Results Carcinosarcoma showed multiple pathological biopsies, with different reports before and after. The tumor surface of the whole laryngeal specimen was smooth, the basal part was small and the section was delicate. The light microscope showed that the tumor had both malignant epithelial components and malignant mesenchyme. Carcinosarcoma is most confused with spindle cell carcinoma morphologically, immunohistochemically, the malignant epithelial components CK (+), VIM (-), and the malignant mesenchyme CK (-), VIM (+) , Spindle cell carcinoma tumor area CK (+), VIM (-). Conclusion The diagnosis of laryngeal carcinosarcoma should be cautious, and it needs a typical pathological morphology and reliable immunohistochemical detection methods and strict evaluation criteria