国际口腔医学杂志 ›› 2022, Vol. 49 ›› Issue (3): 328-331.doi: 10.7518/gjkq.2022046

• 病例报告 • 上一篇    下一篇

伴有广泛角化囊肿的多形性腺瘤1例

翟晓静1(),曹石2,辛文龙3,曹珊1,张皓3()   

  1. 1.兰州大学第一临床医学院 兰州 730000
    2.兰州大学第一医院病理科 兰州 730000
    3.兰州大学第一医院放射科 兰州 730000
  • 收稿日期:2021-08-03 修回日期:2022-01-08 出版日期:2022-05-01 发布日期:2022-05-09
  • 通讯作者: 张皓
  • 作者简介:翟晓静,硕士,Email:691439893@qq.com

Pleomorphic adenoma with extensive keratin cysts: a case report

Zhai Xiaojing1(),Cao Shi2,Xin Wenlong3,Cao Shan1,Zhang Hao3()   

  1. 1.The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China
    2.Dept. of Pathology, The First Hospital of Lanzhou University, Lanzhou 730000, China
    3.Dept. of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, China
  • Received:2021-08-03 Revised:2022-01-08 Online:2022-05-01 Published:2022-05-09
  • Contact: Hao Zhang

摘要:

多形性腺瘤是唾液腺中最常见的良性肿瘤,其组织学形态是多样性的。约25%的多形性腺瘤可伴有鳞化,而伴有广泛鳞化及角化囊肿的病例极其罕见,需要与其他囊性病变、鳞状细胞癌、黏液表皮样癌等进行鉴别。本文报道了1例伴有广泛角化囊肿形成的罕见病例,鳞化及角化囊肿成分约占多形性腺瘤的40%。最终,通过文献复习,笔者总结了伴有广泛角化囊肿的多形性腺瘤的临床病理特征、影像学检查、鉴别诊断、治疗及预后。

关键词: 多形性腺瘤, 伴有广泛角化囊肿的多形性腺瘤, 多形性腺瘤伴鳞化

Abstract:

Pleomorphic adenoma, which has a diverse histology, is the most common benign tumor in the salivary glands. About 25% of pleomorphic adenoma is associated with squamous metaplasia, while cases with extensive squamous metaplasia and keratin cysts are unusual. Thus, there is a need to differentiate this from other cystic lesions, squamous cell carcinoma, mucoepidermoid carcinoma. In this work, we reported a case characterized by extensive keratin cyst formations. Squamous metaplasia and keratin cyst components account for about 40% of pleomorphic adenomas. Finally, through a literature review, we summarized the clinicopathological features, imaging examinations, differential diagnoses, treatments, and prognosis of pleomorphic adenoma with extensive keratin cysts.

Key words: pleomorphic adenoma, pleomorphic adenoma with extensive keratin cyst, pleomorphic adenoma with squamous metaplasia

中图分类号: 

  • R 739.87

图 1

伴有广泛角化囊肿的多形性腺瘤A:肿瘤呈椭圆形,切面灰白、灰黄色,灰黄色区域为角化囊肿区域;B:瘤组织有纤维性包膜[苏木精-伊红染色法(hematoxylin-eosin staining,HE),× 100];C:瘤组织内见大小不等的囊腔,囊腔周围可见黏液软骨样基质(HE,× 40);D:CK8/18示上皮阳性(MaxVision法,× 200);E:P63示肌上皮和鳞状上皮阳性(MaxVision法,× 200);F:P40肌上皮和鳞状上皮阳性(MaxVision法,× 200);G:P53示散在、弱阳性(MaxVision法,× 200);H:KI67指数较低(MaxVision法,× 200)。"

表 1

文献中伴有角化囊肿的多形性腺瘤的临床特征"

参考文献年龄/岁性别部位病程临床表现大小/mm治疗随访
[3]50硬腭1周硬腭后外侧肿胀50×50×15手术不详
[4]16右侧腮腺浅叶1~2年缓慢生长的肿块20×20手术9个月未复发
[5]52上腭1年上腭肿胀15×13×13手术不详
[6]16右侧脸颊部3年右脸颊肿胀15×15手术不详
[7]26右侧腮腺3年坚固、无痛、活动缓慢的肿块30×25×25手术不详
[8]50下颌下腺6个月颌下肿胀50×30手术不详
[9]37口腔前庭10年无痛性肿块20手术不详
[10]62硬腭3~4个月无痛性肿块25×15×8手术不详
[11]21左侧下颌下腺6个月肿块62×75手术不详
[12]54右侧腮腺浅叶20年右侧腮腺区疼痛肿胀1月余17×12×12手术18个月未复发
[13]28眶内颊部6年肿块20×20×15手术不详
[14]28上腭7~8年缓慢生长的无痛肿块10×10手术不详
[15]37左侧腮腺浅叶2年缓慢生长的无痛肿块20×20手术不详
[16]36右侧腮腺4年缓慢生长的无痛肿块70×130×70手术7年未复发
本例32右侧腮腺2年缓慢生长的肿块40×25×20手术6个月未复发
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