鼻窦及扁桃体炎性肌纤维母细胞肿瘤2例临床病理观察

Inflammatory myofibroblastic tumor of paranasal sinus and tonsil: clinical and pathologic analyses of two cases

目的探讨炎性肌纤维母细胞肿瘤(IMT)的临床病理特点、诊断与鉴别诊断。方法对2例IMT的组织病理学、免疫组化结果进行观察分析,结合文献进行讨论。结果 IMT镜下主要由肌纤维母细胞、纤维母细胞和炎细胞组成,表现为黏液丰富区和富于细胞区,梭形和星芒状肿瘤细胞散在或束状排列,间质可见大量纤细扩张的小血管网形成。所有病例vimentin、SMA和Ig G(+),部分病例desmin和CD68(+)。2例目前均存活,1例复发。结论 IMT是一种较为罕见的间叶性肿瘤,主要依据其病理形态学特点并结合免疫表型进行诊断与鉴别诊断。

Objective To investigate the clinical and pathologic features of inflammatory myofibroblastic tumor （IMT）. Methods Two cases of IMT were analyzed with pathological morphology and immunohistochemical staining and review of the related literature. Results Microscopically, there were three kinds of ceils in IMT： myofibrohlast, fihrohlast and inflammatory cells ; the tumor varied from myxoid to highly cellular. The tumor cells were spindle to stellate in shape, widely separated or showed a compact fascicular pattern. There were often associated with mixed inflammatory infiltrates and an irregular meshwork of small dilated vessels. The expression of Vim, SMA and lgG was found in the two eases, while those of DES and CD68 in only one case. Follow-up data were available in the two patients and none died of this disease, but one case had local recurrence. Conclusion IMT is a rare, high- grade sarcoma. The correct diagnosis is based on imaging and pathologic examination as well as immunophenotyping.