嗅神经母细胞瘤9例临床病理及免疫组化分析

Olfactory neuroblastoma: clinicopathological and immunohistochemical changes of 9 cases

目的 探讨嗅神经母细胞瘤的临床病理形态学及免疫组化特点。方法 收集 9例嗅神经母细胞瘤的临床和病理资料 ,用形态学方法和免疫组化染色进行研究。结果 按Kadish分期 :A期 1例 ,B期 7例 ,C期 1例。组织学特征 :瘤细胞呈小圆形或卵圆形 ,被含有多数毛细血管的纤细结缔组织划分为大小不等的片状或梁索状团块 ,核圆形或卵圆形 ,染色质细 ,胞质少 ,有Homer Wright、Flener菊形团 ,细胞间可见胞质突起形成的嗜酸性纤维。 7例中 5例NSE、synaptaphysin、chomograninA(+ ) ,阳性率达 71 4% ;3例NF(+ ) ,4例S 10 0 (+ ) ,1例vimentin(+ ) ,1例keratin(+ ) ,LCA、HMB45、desmin和EMA均为 (-)。结论 NSE、synaptaphysin、chomograninA对诊断嗅神经母细胞瘤有较高的特异性 。

ObjectiveTo investigate the clinicopathologica l and immunohistochemical features of olfactory neuroblastoma MethodsNine patients with detailed clinical data, HE staining and immunohistochemical staining were analyzed ResultsAccording to Ksdish' s staging system, the patients included 1 cases of olfactory neuroblastoma stage A, 7 cases of stage B, and 1 cases of stage C The pathological features showed small round or oval tumor cells arranged in p ieces or trabeculae by fibrous connective tissues, which contained many capillary The tumor cells had round or oval nuclei, and chromatins in small granules, and a high nucleocytoplasmic ratio. Homer-Wright rosette and (or) Flener rosette were found in some cases And acidphilic fibrillary formed by intercytoplasmic processes w as found between tumor cells. Immunohistochemiscal staining showed that neuro-specific enolase (NSE) positive in 5 cases, S-100 protein (S-100) in 4 cases, neurofilament protein (NF) in 3 cases, vimentin protein (vimentin) in 1 case, and kerat in in 1 case. Leucocyte common antigen (LCA), melanoma (HMB45), desmin protein (desmin) were all negative ConclusionNSE is the most useful diagnostic marker for olfactory neuroblastoma; NF, S-100, keratin, LCA, vimentin, HMB45, and desmin may help in the diagnosis