47例软组织颗粒细胞瘤临床病理分析

Soft tissue granular cell tumors:a clinicopathologic analysis of 47 cases

目的回顾性分析47例软组织颗粒细胞瘤(GCT)的临床病理特征并行增殖活性检测。方法收集1975至2008年武汉大学附属医院病理科GCT存档资料47例,分析其临床及组织病理学特征并随访,应用免疫组化方法行S-100、CD68、NSE及Ki-67染色。结果 GCT好发于舌部,女性多见。镜下观察所有肿瘤由多边形瘤细胞组成,胞质中有丰富的嗜酸性颗粒,且S-100、CD68及NSE染色均为阳性。24例良性GCT呈膨胀性生长,其余20例良性及3例细胞不典型性病例均为侵袭性生长。少数肿瘤细胞Ki-67染色阳性。随访的30例中1例肿瘤细胞明显呈不典型性者复发并死亡,1例细胞典型性者复发后组织学呈不典型性,1例细胞典型性者复发两次后组织学呈恶性,27例无复发。结论大多数软组织GCT为良性,少数具有潜在恶性,应注意随访。少数肿瘤细胞Ki-67阳性提示该肿瘤具有较低的增殖活。

Purpose To analysis the clinical and histological features of soft tissue granular cell tumors （GCT） retrospectively and to evaluate their proliferative activity.Methods Clinical and microscopic features were assessed in 47 patients with soft tissues GCT.Immunohistochemical staining for S-100,NSE,CD68 and Ki-67 was conducted.Results Female had more prevalence than male.Tongue was the most commonly affected organ.Histologically,the lesions consisted of polygonal cells with abundant,granular cytoplasm.Follow-up showed atypical GCT had higher potential recurrence and potency of malignant transformation.Immunohistochemical analysis showed that 100% of granular cells had moderated or strong staining of S-100,neuron specific enolase （NSE） and CD68.Nuclear expression of Ki-67 was very low in benign and nonrecurrent typical GCT,but was significantly increased during GCT recurrence and with malignant transformation.Conclusions The majority of GCTs are benign,only a few have malignant potential.Benign GCT has lower proliferation activity.Follow-up is necessary to monitor tumor recurrence and malignant transformation.