喉部癌肉瘤的病理及免疫组化诊断

Pathology and Immunohistochemistry Diagnosis in Carcinosarcoma of Larynx

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。

To study the diagnosis and differential diagnosis of carcinosarcoma of the larynx. Methods Ten cases of squamous cell carcinoma,three cases of spindle cell carcinoma,two cases of carcinosarcoma,six ca- ses of malignant lyphoma,four cases of malignant fibrohistiocytoma and four cases of rhabdomyosarcoma of the larynx were studied by light microscopy and immunohistochemistry. Results The patients with carcinosarcoma of the larynx always have a different results of several times biopsy.Total laryngectomy specimen showed the mass smooth,base small and cut surface delicate.Histological feature of carcinosarcoma of the larynx has both sarcomatous and epithelial malignant components.Immunohistochemical studies showed that CK was present in epithelial cell and negative in sarcoma,whereas VIM was present in sarcoma,but negative in carcinoma. Conclusions The diagnosis for the carcinosarcoma of the larynx should include both typical histological features and substantial immunohistochemical teses.