口腔颗粒细胞瘤的临床病理分析

Clinicopathological analysis of oral granular cell tumor

目的 探讨口腔颗粒细胞瘤的临床表现、病理特征及治疗方案,旨在为其诊断及治疗方案提供参考依据。方法 对我院诊断为颗粒细胞瘤病例的组织病理根据Fanburg-Smith的6项标准进行分类,分为良性、不典型性及恶性肿瘤,并对所有病例的临床表现、病理特征及治疗方案进行回顾性分析。结果 本组共14例,好发年龄40~60岁(8例,57.14%),男女比例1:1,舌部12例(85.71%),颊部和舌下腺各1例。主要表现为无痛性缓慢生长的结节或肿块,9例(64.29%)无明显临床症状,4例(28.57%)表现为疼痛、舌体麻木,1例出现舌体固定,造成吞咽及语音困难。病理表现为肿瘤由丰满的嗜酸性粒细胞构成,胞质内含大量均质颗粒,良性8例(57.14%),不典型性2例(14.29%),恶性4例(28.57%)。所有病例均行手术治疗,1例恶性病例随访2年后失访,其余预后良好。结论 口腔颗粒细胞瘤主要表现为舌部良性肿瘤,根据其组织病理分型不同其治疗要点有所不同,手术彻底切除是其主要治疗方案,总体预后良好。

Objective To explore the clinical manifestations,histopathological features and treatment of oral granular cell tumor,in order to provide reference for its diagnosis and treatment.Methods The histopathological features of granular cell tumor diagnosed in our hospital were classified into benign,atypical and malignant according to the six criteria proposed by Fanburg-Smith,and the clinical manifestations,histopathological features and treatment methods of all cases were retrospectively analyzed.Results There were 14 cases in this group,with a predilection age of 40-60 years old(8 cases,57.14%);the ratio of male to female was 1:1,12 cases(85.71%)in the tongue,1 case in the cheek and 1 case in the sublingual gland.The main manifestations were painless slow growing nodules or masses.Nine cases(64.29%)had no obvious clinical symptoms;4 cases(28.57%)had pain and numbness of the tongue,and 1 case had fixation of the tongue,resulting in difficulty in swallowing and speech.Pathological findings showed that the tumors were composed of abundant eosinophils with a large number of homogeneous granules in the cytoplasm.There were 8 cases of benign(57.14%),2 cases of atypical(14.29%),and 4 cases of malignant(28.57%).All cases received surgical treatment.One malignant patient was lost to follow-up after 2 years,and the prognosis of other cases was good.Conclusion Oral granular cell tumors are mainly benign tumors of the tongue,and their treatment key points vary according to its histopathological types.Surgical resection is the main treatment plan,and the overall prognosis is good.