阑尾低级别黏液性肿瘤12例临床病理分析

Clinicopathologic analysis of low grade appendiceal mucinous neoplasm

为探讨阑尾低级别黏液性肿瘤（LAMN）的临床病理学特点,观察2011年7月15日至2015年7月20日我院12例阑尾LAMN患者的组织学特点,并结合文献探讨其临床病理学特征及诊断、鉴别诊断.10例患者表现为右下腹痛,5例B超或CT检查示阑尾占位或脓肿,2例患者因体检发现回盲部囊性占位.12例患者阑尾LAMN大体上均表现为阑尾增粗,切面呈囊性,囊内充满胶冻状物;镜下均可见阑尾腔扩大,阑尾腔面内衬单层黏液柱状上皮,细胞伴轻度异型性,部分区域呈乳头状增生;阑尾腔部分破裂,阑尾壁见大量黏液,6例黏液中见钙化物质,2例见漂浮的破碎上皮样细胞.2例阑尾壁内钙化血吸虫卵沉着.正确认识LAMN的临床病理学特征,对LAMN的治疗、判断预后具有重要的指导意义.

The clinicohistological features of 12 patients with low grade appendiceal mucinous neoplasm admitted from July 2011 to July 2015 were retrospectively analyzed.Ten patients complained lower abdominal pain,5 cases presented space occupying lesions or abscess in appendix with ultrasound or CT examination,2 cases presented cystic space occupying lesions in ileocecus on medical examination.The patients were generally characterized by enlargement of appendix,and cystic formation filled with jelly material.Histopathology showed appendix cavity expansion,lining single-layer mucus columnar epithelium with mild atypia and local papillary hyperpasia;appendix cavity partly bursted,and a large amount of mucus filled with appendix wall.Calcifications were found in 6 cases,floating broken epithelioid cells in 2 cases,calcified schistosome eggs in 2 cases.It is significant to understand the clinical and pathological features of LAMN.