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目的探讨牙龈浆细胞肉芽肿的临床病理特点、鉴别诊断、治疗及预后。方法回顾性分析5例牙龈浆细胞肉芽肿的临床病理资料,观察其组织形态特征及免疫组化特点,并结合文献复习。结果患者女性3例,男性2例;年龄41~58岁,平均46岁;3例病变位于上牙龈,2例位于下牙龈,病变平均为2.5 cm×2 cm×1.5 cm大小。巨检:病变表面光滑,个别病例伴有小的糜烂,呈息肉或结节状。镜检:病变表面被覆鳞状上皮,部分上皮增生,病变内纤维母细胞及血管增生,间质为疏松的黏液样基质和胶原,间质中可见大量以浆细胞为主的慢性炎细胞浸润,呈弥漫或多结节状排列;浆细胞分化成熟,局部可见透明小体。免疫组化示浆细胞呈κ和λ轻链多克隆表达。结论牙龈浆细胞肉芽肿是一种少见的肿瘤样病变,生物学行为良性,其诊断需结合组织形态及免疫表型,并需与其他富于慢性炎细胞的肿瘤性病变鉴别。
Objective To investigate the clinicopathological features, differential diagnosis, treatment and prognosis of gingival crepocyte granuloma. Methods The clinical and pathological data of 5 cases of gingival plasminogen granuloma were retrospectively analyzed. The histopathological features and immunohistochemical characteristics were observed. Results There were 3 females and 2 males, aged from 41 to 58 years (average 46 years). Three lesions were located in the upper gingiva and two in the lower gingiva. The average lesion size was 2.5 cm × 2 cm × 1.5 cm. Giant seized: smooth surface lesions, with a few cases of small erosion erosion, polyps or nodular. Microscopic examination: the lesion was covered with squamous epithelium, some epithelial hyperplasia, fibroblast and vascular hyperplasia in the lesion, interstitial loose myxoid matrix and collagen, and a large number of chronic inflammatory cells infiltrating into the interstitium, Was diffuse or more nodular arrangement; plasma cells mature, partially visible transparent body. Immunohistochemistry showed that plasma cells showed polyclonal expression of κ and λ light chains. Conclusion Gingival plasmacytoma granuloma is a rare tumor-like lesion with benign biological behavior. Its diagnosis needs to be combined with histomorphology and immunophenotype, and it needs to be differentiated from other neoplastic lesions rich in chronic inflammatory cells.