喉非鳞状细胞癌的临床病理学特征

Clinical pathology features of non-squamous cell carcinoma of larynx

目的探讨原发于喉部的非鳞状细胞癌的临床病理学特点,提高诊断和治疗水平。方法回顾性分析20例喉非鳞状细胞癌患者的临床和随访资料,采用HE染色和免疫组化法观察其组织病理学改变及免疫表型。结果①组织学类型,非上皮源性恶性肿瘤12例,其中小细胞癌3例、恶性纤维组织细胞瘤2例、纤维肉瘤1例、恶性淋巴瘤4例和髓外浆细胞瘤2例;上皮源性肿瘤8例,其中多形性腺瘤恶变2例、疣状癌5例和腺样囊性癌1例;②治疗方法,除1例恶性淋巴瘤、1例髓外浆细胞瘤和1例小细胞癌行放射治疗和(或)化学治疗外,其他17例均首选手术治疗,部分联合放射治疗和(或)化学治疗;③随访,1例死亡,3例失访,其他患者均存活至今。结论该病临床少见,容易误诊,免疫组化检查有助于确诊,临床上应根据组织病理学特点选用手术切除、放射治疗或化学治疗。

OBJECTIVE To explore the clinical characteristics of primary laryngeal non-squamous cell carcinoma and to improve the level of diagnosis and traetment. METHODS The clinical data of 20 patients with laryngeal non-squamous cell carcinoma were studied retrospectively. The histopathology and immunophenotype were observed by HE staining and immunohistochemistry. RESULTS （1）There were 12 cases of nonepithelial malignant tumor （including 3 small cell carcinomas, 2 malignant fibrohistiocytoma, 1 laryngeal fibrosarcoma, 4 malignant lymphoma and 2 extramedullary plasmocytomas） and 8 cases of epithelial malignant tumor （including 2 malignant pleomorphic adenoma, 5 verrucous carcinoma and 1 adenoid cystic carcinoma）. （2）The choice of radiation therapy and /or chemotherapy were used in 1 malignant lymphoma case, 1 extramedullary plasmocytoma case and 1 small cell carcinoma case. Other 17 cases underwent operation first and some combined with radiation therapy and /or chemotherapy. （3）Follow up： One case died, 3 cases were lost for follow up, and other patients were survived up to now. CONCLUSION The primary laryngeal non-squamous cell carcinoma is a rare disease and easy to be misdiagnosed. The choice of management based on histopathologic features. Immunohistochemistry is helpful for diagnosis.