口咽部滤泡树突状细胞肉瘤的诊断与治疗:附病例分析

Two Cases Reports of Follicular Dendritic Cell Sarcoma

目的提高临床医师对口咽部滤泡树突状细胞肉瘤的认识,以便早期诊断、治疗,提高患者的生存率。方法报道我院2例口咽部滤泡树突状细胞肉瘤患者的临床和随诊资料,并结合相关文献对该病的临床特点、组织病理学特征、诊断、治疗及预后进行分析。结果口咽部滤泡树突状细胞肉瘤无特征性临床表现。组织学表现为瘤细胞呈椭圆形,瘤组织弥漫分布,瘤组织间常夹杂小淋巴细胞。免疫组化检查示CD21(+)、CD35(+)、clusterin(+)、表皮生长因子受体(+),ki-67表达程度不一。手术加化疗后随访18个月,局部无复发,无全身其他系统转移。结论口咽部滤泡树突状细胞肉瘤形态学变化较大,诊断需要依靠详细的病理形态观察及多种免疫组化标记,治疗以手术切除为主。辅以化疗预后良好。

Objective To investigate the clinical and pathological character of the tonsillar dendritic cell saroma and to improve the diagnostice and treatment level.Methods The histopathological,immunohistochemical examination,and clinical observations were analyzed in tonsillar dendritice cell sarcoma.Results The tonsillar dendritic cell sarcoma had no charactreistic clinical manifestations.Histology indicated that sarcoma cell was ellipse,sarcoma tissue distributed pervasively and often mixed with some lymphoid cells,Immunohistochemical marking showed CD21,CD35,clusterin（＋）.In the 18-month follow-up,after the surgical treatment and chemotherapy,no recurrence was found locally or systematically.Conclusion The tonsillar dendritic cell saroma was a rare malignant tumor,and its diagnosis depends on the histopathological and immunohistochemical marking.Surgical operation is the first choice of treatment,and postoperative chemotherapy and radiotherapy is effective with good prognosis.