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喉炎症性肌纤维母细胞瘤临床与组织病理分析

Clinical manifestation and histopathology of inflammatory myofibroblastic tumor in larynx

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【作者】 任晓勇罗花南成颖侯瑾康全清

【Author】 Ren Xiaoyong;Luo Huanan;Cheng Ying;Hou Jin;Kang Quanqing;Department of Otolaryngology Head and Neck Surgery,The Second Affiliated Hospital,Medical School of Xi ’an Jiaotong University;

【机构】 西安交通大学医学院第二附属医院耳鼻咽喉头颈外科病院

【摘要】 目的:探讨喉炎症性肌纤维母细胞瘤患者的临床及组织病理特点。方法:回顾性分析2005年5月至2012年12月收治的5例喉炎症性肌纤维母细胞瘤的组织病理、临床表现、治疗方法和预后。结果:本组5例患者病变位于声带或声门下,4例患者采用显微喉镜下二氧化碳激光切除术,其中1例因术后复发采用全喉切除术;另1例患者行喉裂开肿物切除术。所有手术切除标本均行免疫组化检测,结果显示Vim(+),SMA(+),Des(-),CK(-),Ki67(+)<3%,确诊为喉炎症性肌纤维母细胞瘤。术后随访11-66个月不等,均恢复良好,无咽瘘、感染等并发症发生,1例行气管切开+喉裂开术的患者术后3月顺利拔管,1例行气管切开+全喉切除术的患者术后长期带管,但均未见复发和转移。结论:喉炎症性肌纤维母细胞瘤的诊断有赖于临床特点、组织病理学及免疫组化检查。本病尚无统一治疗方案,以手术切除为主,存在复发的潜在可能,术后需密切随访。

【Abstract】 Objective:To summarize the clinical pathological characteristics of laryngeal inflammatory myofibroblastic tumor.Methods:Clinical manifestation,treatment method and prognosis of 5 cases of laryngeal inflammatory myofibroblastic tumor from May 2005 to December 2012 were analyzed retrospectively.Results:All the lesions in patients were located in the vocal cords or subglottic region.4 cases were treated by carbon dioxide laser resection under laryngoscope,including 1 case with total laryngectomy for postoperative recurrence,and 1 case was treated by laryngofissure.All the surgically resected specimens were performed immunohistochemical detection,and the results showed that Vim(+),SMA(+),Des(-),CK(-),Ki67(+)<3%.From which it could be diagnosed as laryngeal inflammatory myofibroblastic tumor.All the patients were postoperatively followed-up for 11-66 months,and recovered well without pharyngeal fistula,infection and other complications,including a patient underwent tracheotomy and laryngofissure was successful extubation in 3 months after postoperation,1 patient underwent tracheotomy and total laryngectomy with tracheal tube for a long time,but without recurrence and metastasis.Conclusion:Correct diagnosis of laryngeal inflammatory myofibroblastic tumor depends on clinical features,histopathologic and immunohistochemical examination.There is no unified treatment for the disease,but surgical resection is still the main treatment mehod.Closely postoperative follow up is necessary for laryngeal inflammatory myofibroblastic tumor patients because of its recurrence potential.

【关键词】 纤维母细胞瘤喉肿瘤预后
【Key words】 fibroblast tumorlaryngeal neoplasmprognosis
  • 【文献出处】 现代肿瘤医学 ,Journal of Modern Oncology , 编辑部邮箱 ,2013年11期
  • 【分类号】R739.65
  • 【被引频次】3
  • 【下载频次】118
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