毛母质瘤的病理特征与超声表现

Ultrasonic appearance and pathologic changes of pilomatricoma

目的探讨毛母质瘤的超声表现及病理变化情况。方法回顾性分析我院经手术和病理证实的35例毛母质瘤患者临床资料,对比分析其超声表现和病理特征。结果根据声像图瘤体内有无钙化可将35例毛母质瘤分为实质有钙化型27例,实质无钙化型8例。术前超声诊断27例实质有钙化型病灶内部见散在点状、斑片状强回声者22例,弧形强回声伴声影5例,超声均能对其做出明确诊断。8例实质无钙化型病灶内均未见钙化强回声,其中6例做出明确诊断,占75%,1例误诊为皮脂腺囊肿,1例误诊为腮腺混合瘤。电镜下观察病理组织可见大量影子细胞,排列呈片状,伴有嗜碱性细胞。结论实质内钙化是超声表现为不同形态强回声的病理学基础,影子细胞是诊断毛母质瘤的特征性病理表现;毛母质瘤具有一定的超声声像图特点,熟悉其表现可以提高对该病的术前诊断率。

Objective To explore the ultrasonic appearance and pathologic changes of pilomatricoma. Methods Thirty-five patients with pilomatrieoma were confirmed by surgery and pathology, their ultrasonic appearance and pathologic changes were compared and analyzed. Results Thirty-five patients were divided into calcific group and no-calcific group, including 27 cases of calcification type and 8 cases of no-calcification type. The punctiform and magnophyric strong echo was observed in 22 cases of calcification type, and strong echo with shadow in 5 cases. While there was no calcification strong echo in 8 cases of no-calcification type, 6 cases were diagnosed by uhrasonography（75% ） , 1 case was misdiagnosed as sebaceous cyst, the other 1 case was misdiagnosed as mixed tumor of parotid gland. A lot of shadow cells an：anged as lamellar with basophilic cells were observed under the electron microscope. Conlusion Calcification is the pathological basis of different strong echo in ultrasonography, shadow cell is the specific pathological appearance in diagnosis of pilomatrieoma. Pilomatricoma has certain ultrasonic characteristics, which can improve the preoperative diagnosis of this disease.