【摘要】：目的對牙源性鈣化上皮瘤的病理診斷、鑒別診斷和預后進行分析。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行臨床病理分析,并復習相關文獻。結果 3例牙源性鈣化瘤中2例位于下頜骨內,1例位于上頜骨內。鏡下腫瘤由纖維間質和多邊形上皮細胞島及團片構成。腫瘤細胞含豐富的嗜酸性胞質,細胞間界限非常清楚,有分化良好的細胞間橋;細胞核常呈多形性,巨型核常見,核分裂象罕見。在腫瘤細胞團片中央或其外周,可見嗜酸染色的、均一的透明物質,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:上皮細胞p63和HCK(+)。隨訪:1例術后6年復發(fā),1例術后2年無復發(fā),1例術后恢復中。結論牙源性鈣化上皮瘤較少見,腫瘤有獨特的病理組織學特點,可向局部侵襲性生長,需要與骨內原發(fā)或轉移的鱗狀細胞癌、涎腺的惡性腫瘤(包括黏液表皮樣癌和腺泡細胞癌)、腎透明細胞癌轉移等相鑒別。手術切除不徹底可復發(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】： 湖北文理學院附屬襄陽市中心醫(yī)院;
【分類號】：R739.8

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