口腔黏膜髓外髓细胞肉瘤3例临床病理分析

The clinical pathological analysis of extramedullary myeloid sarcoma of oral mucosa:three case reports

目的探讨髓外髓细胞肉瘤(EMS)的临床病理学特征、诊断及鉴别诊断,以加深对该病的认识。方法结合文献对2006—2007年中国医科大学口腔医学院收治的3例口腔黏膜EMS的临床表现、组织形态学特点、免疫组化及治疗和预后进行分析。结果3例口腔黏膜EMS均以牙龈肿胀为首要表现,形态学上肿瘤细胞弥漫分布,小至中等大小,胞质少,核圆形、椭圆形,染色质细腻,核分裂易见。免疫组化显示3例髓过氧化物酶(MPO)均呈阳性,2例CD43、CD117阳性。结论EMS是一种罕见肿瘤,仅凭形态学易误诊为淋巴瘤、小细胞癌等,利用免疫组化有助于诊断和鉴别诊断,以便对患者进行恰当的治疗。

Objective To approach the clinical and pathologic features,diagnosis and differential diagnosis of extramed-ullary myeloid sarcoma in order to know more about it.Methods The clinical manifestations,histomorphology featru-res,immunohistochemistry,treatment and prognosis were analyzed in three cases of extramedullary myeloid sarcoma of the mouth mucosa with review of the literatures.Results Three cases of extramedullary myeloid sarcoma of the mouth mucosa all presented gingival enlargement.Morphologically,the tumor cells grew in a diffuse pattern and were small to medium in size,with scant cytoplasm,round or oval nuclear,exquisite chromatin,and frequent karyokinesis.Immunohis-tochemistry for MPO were all positive in three cases,and CD43 and CD117 were positive in two cases.Conclusions Extramedullary myeloid sarcoma is rare.Only with morphology,it may be misdiagnosed as lymphoma,small cell carcino-ma and so on.Immunohistochemistry can contribute to diagnosis and differential diagnosis so as to guide the doctors to give patients appropriate treatment.