摘要
目的探讨肾上腺混合性嗜铬细胞瘤的临床和病理学特征,了解病理特点、鉴别诊断及预后情况,以提高认识。方法分析1例肾上腺混合性嗜铬细胞瘤的临床资料,电话随诊患者;HE染色、光镜下观察其组织学表现,并进行免疫组化染色。结果光镜观察,肿瘤中可见两种不同类型的细胞区域:一种为瘤细胞排列成不规则巢团状,以小巢团为主,核圆形或卵圆形,胞浆细颗粒状、嗜碱性或者双嗜性,分裂象罕见;一种为束状及编织状排列的施万细胞背景下,散在及聚集分布怪异、多核性神经节细胞,免疫组化显示前一区域瘤细胞CgA、Syn强阳性,后一区域S-100弥漫强阳性,其间神经节细胞NF强阳性。结论肾上腺混合性嗜铬细胞瘤临床罕见,临床表现不一,病理是目前唯一准确诊断手段,手术切除是治疗的最佳选择,术后随访是必要的。
Objective By investigating the clinical and pathological features of composite pheochromocytoma of the adrenal gland( pheo-chromocytoma-ganglioneuroma),to understand the pathological characteristics,differential diagnosis and prognosis,and to improve the under-standing to this disease. Methods one case of composite pheochromocytoma of adrenal gland was analyzed on clinical materials and follow-up data was obtained by telephone. Adopting HE staining and immunohistochemical staining,the histological features and immunohistochemical ex-pression of the tumor were analyzed. Results Microscopically,two different types of cells could be seen:one type of tumor arranged in irregular nests,maily in small nests with round or oval nuclei,fine granular and basophilic or amphophilic cytoplasm,mitoses were rare;the other type area was scattered and aggregated distributed and strange nuclear ganglion cells,in the background of Schwann cells which aligned bundles and interwo-ven. The tumor cells of the former areas were strongly positive for CgA and Syn,and scattered spindle cells were positive for S-100. As to the lat-ter,tumor cells were strongly positive for NF. Conclusion Composite pheochromocytoma of adrenal gland is rare. It has diversified clinical mani-festations. Biopsy is the only accurate diagnostic method. Surgical resection is the best choice for treatment,postoperative follow-up is necessary.
出处
《临床和实验医学杂志》
2014年第19期1633-1636,共4页
Journal of Clinical and Experimental Medicine
关键词
肾上腺肿瘤
混合性嗜铬细胞瘤
免疫组织化学
Adrenal gland neoplasms
Composite Pheochromocytoma
Immunohistochemistry