头颈部肌纤维瘤22例临床病理分析

Myofibroma of the head and neck region: Clinical and histopathological analyses of 22 cases

目的:总结头颈部肌纤维瘤的临床病理特点。方法:纳入22 例头颈部肌纤维瘤患者的临床资料,并对其组织切片进行HE 和免疫组化染色分析。结果: 22 例头颈部肌纤维瘤病例男女各11 例,中位年龄6. 5 岁,多见于下颌骨( 7 例)、下颌牙龈( 5 例)。影像学表现为近肌组织密度的占位性病变。光镜下可见双相表现,免疫组化: Vimentin(+),SMA(+),Calponin(+),Desmin(-),Caldesmon(-)。平均随访时间21 个月,3例术后复发,局部切除( n = 14)和扩大切除( n = 8)与肿瘤复发率无显著相关性( P = 0. 15)。结论:头颈部肌纤维瘤好发于儿童,局部病灶切除或颌骨病灶刮治手术预后好。免疫组化染色对肌纤维瘤病理诊断意义重大。

Objective: To study the clinical and histopathologic features of myofibroma in head and neck region. Methods: 22 cases of myofibroma in head and neck region were retrospectively analyzed by morphological observation and immunohistochemistry. Results: There were 11 males and 11 females of the 22 cases with a median age of 6. 5 years. The lesion in mandible and gingiva was in 7 and 5 cases respectively. The imaging findings showed masses of similar density with muscle. Histopathological examination revealed a biphasic pattern. The immunohistochemical tests showed vimentin(+),SMA(+),calponin(+),desmin(-),caldesmon(-). Tumor recurrence was found in 3 patients after an average 21-month follow-up. No significant difference( P = 0. 15) between the conservative operation group( n = 14) and the radical operation group( n = 8). Conclusion: Myofibroma mostly develops in children in head and neck region. Local and complete excision is recommended for favorable outcomes. Immunohistochemical stain plays an important role in pathological diagnosis.