【摘要】：目的對牙源性鈣化上皮瘤的病理診斷、鑒別診斷和預(yù)后進(jìn)行分析。方法用光鏡觀察、免疫組化、特殊染色對3例牙源性鈣化上皮瘤進(jìn)行臨床病理分析,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 3例牙源性鈣化瘤中2例位于下頜骨內(nèi),1例位于上頜骨內(nèi)。鏡下腫瘤由纖維間質(zhì)和多邊形上皮細(xì)胞島及團(tuán)片構(gòu)成。腫瘤細(xì)胞含豐富的嗜酸性胞質(zhì),細(xì)胞間界限非常清楚,有分化良好的細(xì)胞間橋;細(xì)胞核常呈多形性,巨型核常見,核分裂象罕見。在腫瘤細(xì)胞團(tuán)片中央或其外周,可見嗜酸染色的、均一的透明物質(zhì),剛果紅染色顯示為淀粉樣物,并常以同心圓的方式發(fā)生鈣化。鈣化是該腫瘤的特征。免疫組化:上皮細(xì)胞p63和HCK(+)。隨訪:1例術(shù)后6年復(fù)發(fā),1例術(shù)后2年無復(fù)發(fā),1例術(shù)后恢復(fù)中。結(jié)論牙源性鈣化上皮瘤較少見,腫瘤有獨特的病理組織學(xué)特點,可向局部侵襲性生長,需要與骨內(nèi)原發(fā)或轉(zhuǎn)移的鱗狀細(xì)胞癌、涎腺的惡性腫瘤(包括黏液表皮樣癌和腺泡細(xì)胞癌)、腎透明細(xì)胞癌轉(zhuǎn)移等相鑒別。手術(shù)切除不徹底可復(fù)發(fā),建議臨床長期隨訪。
[Abstract]:Objective to analyze the pathological diagnosis, differential diagnosis and prognosis of odontogenic calcified epithelioma. Methods three cases of odontogenic calcified epithelioma were analyzed by light microscopy, immunohistochemistry and special staining. Results among 3 cases of odontogenic calcification, 2 cases were located in the mandible and 1 case in the maxilla. Microscopically, the tumor consists of fibrous stroma and polygonal epithelial islands and lumps. Tumor cells are rich in eosinophilic cytoplasm and have well-differentiated intercellular bridges. The nuclei are often pleomorphic, giant nuclei are common, and mitosis is rare. In the center of tumor cell mass or its periphery, acidophilic and homogeneous transparent substance can be seen. Congo red staining shows amyloid, and calcification often occurs in concentric way. Calcification is characteristic of the tumor. Immunohistochemistry: p63 and HCK (). In epithelial cells Follow up: 1 case recurred 6 years after operation, 1 case did not recur 2 years after operation, 1 case recovered. Conclusion Odontogenic calcified epithelioma is rare. It has unique histopathological features and can be locally invasive. It needs to be associated with intraosseous primary or metastatic squamous cell carcinoma. Malignant tumors of salivary gland (including mucoepidermoid carcinoma and acinar cell carcinoma) and metastasis of renal clear cell carcinoma are distinguished. Surgical resection can not be completely recurrence, clinical long-term follow-up is recommended.
【作者單位】： 湖北文理學(xué)院附屬襄陽市中心醫(yī)院;
【分類號】：R739.8

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