鼻咽部滤泡树突状细胞肉瘤1例及文献复习

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摘要探讨鼻咽部滤泡树突状细胞肉瘤（FDCS）的临床和病理特点，提高对其诊治水平。回顾分析1例发生在鼻咽部的FDCS 临床表现、组织学特点和免疫表型，并对患者进行长期随访，同时对国内外报道的相关文献进行复习。患者，男，36岁，因“右侧渐进性鼻塞2月余”入院。包块最大径2.5 cm，肿瘤细胞弥漫排列成片状，细胞异型明显，呈卵圆形、梭形，似“合体细胞”样，见少量多核瘤细胞及大量核分裂象。局灶区域可见扩张的假血管腔隙和血管周围淋巴鞘，肿瘤周围可见凝固性坏死。免疫组化：CD21 和CD23 弥漫（+），CD35 灶状（+），EMA（++），CK（-），Ki-67 指数80%，原位杂交EBV（-）。密切随访患者12年无复发或转移。鼻咽部FDCS非常罕见，明确诊断需结合组织病理学形态和免疫组化表型，本例随访结果支持鼻咽部FDCS是一种中间型肿瘤，病灶局限的肿瘤根治性切除即可治愈。

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	钱伟明
	沈无名
	李可

关键词 ：鼻咽, 树突细胞, 滤泡, 肉瘤, 临床特征

Abstract：The clinical and pathologic characteristics of follicular dendritic cell sarcoma (FDCS) of nasopharynx were investigated, so as to improve the diagnosis and treatment level of the nasopharynx FDCS.The clinical features,histopathological charactersistics and immunophenotype of a case of FDCS in nasopharynx were retrospectively analyzed, the patient was followed-up for a long period of time and the relative literature at home and abroad was reviewed.A 36-year-old male patient was admitted to hospital due to "progressive nasal obstruction on the right side for more than two months".The largest diameter of the tumor was 2.5 cm.The tumor cells were diffusely arranged in a sheet shape, with obvious cell aberrations, oval-shaped, spindle-shaped, like "syncytium cells", and a small number of multinuclear tumor cells and a large number of mitotic figures.In the focal area, dilated pseudovascular spaces and perivascular lymphatic sheaths could be seen and coagulative necrosis could be seen at the periphery.Immunohistochemistry: CD21 and CD23 diffuse (+), CD35 focal (+), EMA(++), CK (-), Ki-67 index 80%, in situ hybridization EBV(-).The patient was closely followed up for 12 years without recurrence or metastasis.FDCS is very rare in nasopharynx，and definite diagnosis should be combined with histopathological morphology and immunohistochemical phenotype.The follow-up results of this case support that nasopharynx FDCS is an intermediate grade tumor, which can be cured by radical resection of the lesion.

Key words： Nasopharynx Dendritic cell Follicle Sarcoma Clinical characteristics

作者简介: 钱伟明（1973-），男，江苏常州人，本科，副主任医师，主要从事病理诊断方面的研究

引用本文:

钱伟明；沈无名；李可. 鼻咽部滤泡树突状细胞肉瘤1例及文献复习[J]. 中国当代医药, 2020, 27(12): 199-202.
QIAN Wei-ming； SHEN Wu-ming； LI Ke. Follicular dendritic cell sarcoma of nasopharynx: a case report and literature review. 中国当代医药, 2020, 27(12): 199-202.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I12/199

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