颌面部颗粒细胞瘤临床病理及免疫组织化学分析

doi:10.7518/hxkq.2023.2023035

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (4): 414-420.doi: 10.7518/hxkq.2023.2023035

颌面部颗粒细胞瘤临床病理及免疫组织化学分析

申泽良(), 姚莉洪, 蒋鸿杰, 李茂, 汤亚玲()

口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院病理科，成都 610041

收稿日期:2023-02-06 修回日期:2023-05-30 出版日期:2023-08-01 发布日期:2023-07-21
通讯作者: 汤亚玲 E-mail:aaronshenzeliang@163.com;tangyaling@scu.edu.cn
作者简介:申泽良，硕士，E-mail：aaronshenzeliang@163.com
基金资助:
四川大学华西口腔医院临床研究项目(LCYJ2019-8)

Clinicopathological and immunohistochemical analysis of maxillofacial granular cell tumor

Shen Zeliang(), Yao Lihong, Jiang Hongjie, Li Mao, Tang Yaling.()

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2023-02-06 Revised:2023-05-30 Online:2023-08-01 Published:2023-07-21
Contact: Tang Yaling. E-mail:aaronshenzeliang@163.com;tangyaling@scu.edu.cn
Supported by:
The Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ2019-8);Correspondence: Tang Yaling, E-mail: tangyaling@scu.edu.cn

摘要/Abstract

摘要：

目的借助免疫组织化学染色分析探讨颌面部颗粒细胞瘤（GCT）的临床组织病理特征。方法回顾性纳入7例颌面部GCT，分析颌面部GCT的镜下形态，免疫组织化学染色检测S-100、神经元特异性烯醇酶、SOX-10、CD68、肌动蛋白、结蛋白与Ki-67在GCT中的表达情况，并随访治疗效果。结果 7例颌面部GCT肿瘤皆缺乏包膜，边界不清。镜下肿瘤细胞胞质内充满特征性嗜酸性颗粒。免疫组织化学结果显示，6例NSE阳性，5例S-100阳性，7例CD68阳性，5例SOX-10阳性，1例肌动蛋白阳性，7例结蛋白阴性，Ki-67阳性比例均不超过5%。随访的6例颌面部GCT均未复发。结论颌面部GCT具有特征性组织学结构，免疫组织化学S-100、CD68等指标可辅助诊断，临床切除后预后良好。

关键词: 颗粒细胞瘤, 临床病理, 免疫组织化学

Abstract:

Objective To analyze the clinicopathological features of maxillofacial granular cell tumors (GCT) with the aid of immunohistochemical staining. Methods Seven cases of maxillofacial GCT were retrospectively collated, and the microscopic morphology of maxillofacial GCT was analyzed. The expression of S-100, neuron-specific enolase (NSE), SOX-10, CD68, actin, desmin, and Ki-67 in GCT was detected by immunohistochemical staining. The cases were observed in the follow-ups after clinical treatment. Results All seven GCT tumors lacked envelopes and were poorly defined. Microscopically, the sizes of the tumor cells were large and appeared with inconspicuous cell membranes, forming a syncytium-like appearance. The cytoplasm was filled with characteristic eosinophilic granules. The immunohistochemical results showed that six cases were NSE-positive, five cases were S-100-positive, seven cases were CD68-positive, five cases were SOX-10-positive, one case was actin-positive, and seven cases were desmin-negative. The Ki-67 index did not exceed 5% in all cases. In the follow-up sessions, none of the six cases presented a recurrence. Conclusion Maxillofacial GCT has a characteristic histological structure. Immunohistochemical S-100, CD68, and other indicators can assist in diagnosis, and the prognosis is good after clinical resection.

Key words: granular cell tumor, clinicopathology, immunohistochemistry

中图分类号:

R 739.8

申泽良, 姚莉洪, 蒋鸿杰, 李茂, 汤亚玲. 颌面部颗粒细胞瘤临床病理及免疫组织化学分析[J]. 华西口腔医学杂志, 2023, 41(4): 414-420.

Shen Zeliang, Yao Lihong, Jiang Hongjie, Li Mao, Tang Yaling.. Clinicopathological and immunohistochemical analysis of maxillofacial granular cell tumor[J]. West China Journal of Stomatology, 2023, 41(4): 414-420.

图/表 5

表 1

表 2

图 1

表 3

图 2

参考文献 24

1	Abrikossoff AI. Uber myome ausgehend vonder quer-gestreiften willkurlichen muskulatur[J]. Virchows Arch, 1926, 260(1): 215-233.
2	Neelon D, Lannan F, Childs J. Granular cell tumor[M]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023.
3	The WHO Classification of Tumours Editorial Board. WHO classification of tumours soft tissue and bone tumours[M]. 5th ed. Lyon: IARC Press, 2020.
4	Battistella M, Cribier B, Feugeas JP, et al. Vascular invasion and other invasive features in granular cell tumours of the skin: a multicentre study of 119 cases[J]. J Clin Pathol, 2014, 67(1): 19-25.
5	Eguia A, Uribarri A, Gay Escoda C, et al. Granular cell tumor: report of 8 intraoral cases[J]. Med Oral Patol O-ral Cir Bucal, 2006, 11(5): E425-E428.
6	Chamberlain BK, McClain CM, Gonzalez RS, et al. Alveolar soft part sarcoma and granular cell tumor: an immunohistochemical comparison study[J]. Hum Pathol, 2014, 45(5): 1039-1044.
7	Gurzu S, Ciortea D, Tamasi A, et al. The immunohistochemical profile of granular cell (Abrikossoff) tumor sug-gests an endomesenchymal origin[J]. Arch Dermatol Res, 2015, 307(2): 151-157.
8	Amphlett A. An update on cutaneous granular cell tumours for dermatologists and dermatopathologists[J]. Clin Exp Dermatol, 2022, 47(11): 1916-1922.
9	Viani MV, Corcione L, Di Blasio C, et al. A single case report of granular cell tumor of the tongue successfully treated through 445 nm diode laser[J]. Healthcare (Basel), 2020, 8(3): E267.
10	van de Loo S, Thunnissen E, Postmus P, et al. Granular cell tumor of the oral cavity; a case series including a case of metachronous occurrence in the tongue and the lung[J]. Med Oral Patol Oral Cir Bucal, 2015, 20(1): e30-e33.
11	Bamps S, Oyen T, Legius E, et al. Multiple granular cell tumors in a child with Noonan syndrome[J]. Eur J Pediatr Surg, 2013, 23(3): 257-259.
12	Martin RW, Neldner KH, Boyd AS, et al. Multiple cu-taneous granular cell tumors and neurofibromatosis in childhood. A case report and review of the literature[J]. Arch Dermatol, 1990, 126(8): 1051-1056.
13	Aragüés IH, Domínguez MC, Blanco VP, et al. LEOPARD syndrome and multiple granular cell tumors: an underreported association[J]. Indian J Dermatol Venereol Leprol, 2016, 82(1): 77-79.
14	李铁军. 临床病理诊断与鉴别诊断——口腔颌面部疾病[M]. 北京: 人民卫生出版社, 2020: 325.
	Li TJ. Clinicopathological diagnosis and differential dia-gnosis—oral and maxillofacial diseases[M]. Beijing: Peo-ple’s Medical Publishing House, 2020: 325.
15	Goldbach A, Gupta Y, Caroline D, et al. Granular cell tumor: the great mimicker[J]. Breast J, 2019, 25(3): 521-522.
16	Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation[J]. Am J Surg Pathol, 1998, 22(7): 779-794.
17	Dhillon AP, Rode J. Immunohistochemical studies of S-100 protein and other neural characteristics expressed by granular cell tumour[J]. Diagn Histopathol, 1983, 6(1): 23-28.
18	Ogawa K, Nakashima Y, Yamabe H, et al. Alveolar soft part sarcoma, granular cell tumor, and paraganglioma. An immunohistochemical comparative study[J]. Acta Pa-thol Jpn, 1986, 36(6): 895-904.
19	Filie AC, Lage JM, Azumi N. Immunoreactivity of S100 protein, alpha-1-antitrypsin, and CD68 in adult and congenital granular cell tumors[J]. Mod Pathol, 1996, 9(9): 888-892.
20	Pareja F, Brandes AH, Basili T, et al. Loss-of-function mutations in ATP6AP1 and ATP6AP2 in granular cell tumors[J]. Nat Commun, 2018, 9(1): 3533.
21	Sekimizu M, Yoshida A, Mitani S, et al. Frequent mutations of genes encoding vacuolar H⁺-ATPase components in granular cell tumors[J]. Genes Chromosomes Cancer, 2019, 58(6): 373-380.
22	Epstein DS, Pashaei S, Hunt E, et al. Pustulo-ovoid bo-dies of Milian in granular cell tumors[J]. J Cutan Pathol, 2007, 34(5): 405-409.
23	Avalos HS, Manci E, Mulekar M, et al. Congenital granular cell epulis: 24 new cases with more differences than similarities to granular cell tumor[J]. Ultrastruct Pathol, 2022, 46(4): 388-400.
24	郑琛, 苏吉梅, 梁鑫, 等. 先天性颗粒细胞龈瘤的临床病理分析[J]. 华西口腔医学杂志, 2022, 40(6): 710-715.
	Zheng C, Su JM, Liang X, et al. Clinical and pathological analysis of congenital granular cell tumor[J]. West China J Stomatol, 2022, 40(6): 710-715.

序号	确诊年份	性别	年龄/岁	部位	肿瘤最大直径/mm	病程	治疗方式	随访情况	随访时间/月
1	2013	女	44	舌背	20	1年	L	无复发	109
2	2014	女	19	左下牙龈	5	6个月	L	无复发	108
3	2014	女	14	右舌缘	30	1年余	G	无复发	100
4	2018	女	39	右舌缘	5	1年	L	无复发	55
5	2020	女	35	左颊黏膜	10	2年	G	无复发	25
6	2021	男	4	左舌腹	25	1年	G	无复发	15
7	2022	男	33	右侧舌背	15	6个月	G	手术时间不足1年，未随访	-

序号	生长模式	炎细胞浸润	侵犯肌肉	侵犯神经	侵犯血管	有假上皮瘤样增生	有上皮内肿瘤岛
1	侵袭性	-	+	+	+	+	+
2	侵袭性	-	-	-	+	+	+
3	侵袭性	-	+	+	+	+	+
4	侵袭性	-	+	-	+	+	+
5	侵袭性	+	-	-	+	+	+
6	侵袭性	+	+	-	+	-	-
7	侵袭性	+	+	+	+	+	+

序号	NSE	S-100	CD68	SOX-10	Actin	Desmin	Ki-67
1	+	+	+	+	-	-	<1% +
2	-	-	+	-	-	-	3% +
3	+	+	+	部分+	-	-	1% +
4	+	+	+	+	-	-	<1% +
5	+	+	+	+	-	-	<1% +
6	+	-	+	-	+	-	3%~5% +
7	+	+	+	+	-	-	<1% +

[1]	唐月阳, 万梓欣, 姚莉洪, 吴兰雁, 何志秀, 汤亚玲. 牙源性始基瘤1例[J]. 华西口腔医学杂志, 2022, 40(3): 350-354.
[2]	付汉斌, 罗琳. HOX反义基因间RNA在唾液腺腺样囊性癌组织中的表达及对预后的影响[J]. 华西口腔医学杂志, 2020, 38(5): 509-512.
[3]	代璐岭, 杨秀秀, 赵好为, 韩琪, 陈宇. 牙龈基底细胞样鳞状细胞癌1例[J]. 华西口腔医学杂志, 2020, 38(3): 343-346.
[4]	吴家顺, 张伟龙, 李竹风, 王浩帆, 杨肖, 张美, 杨名仲, 陈宇, 汤亚玲. 下颌骨朗格汉斯细胞组织细胞增生症1例[J]. 华西口腔医学杂志, 2020, 38(2): 224-227.
[5]	曾晓华蔡巧玲宫苹. 犬牙周膜中神经纤维的形态特点及分析[J]. 华西口腔医学杂志, 2016, 34(5): 459-462.
[6]	陈俊李姬梅李伟胡红梅. 中期因子和微血管密度在涎腺腺样囊性癌组织中的表达[J]. 华西口腔医学杂志, 2016, 34(2): 189-193.
[7]	乌玉红吕威王瑞梅. 牙龈髓细胞肉瘤1例[J]. 华西口腔医学杂志, 2015, 33(1): 107-108.
[8]	张卫兵王林. 上颌快速扩弓腭中缝血管内皮生长因子的时空表达与新骨形成的相关性研究[J]. 华西口腔医学杂志, 2014, 32(6): 561-565.
[9]	贾洁茹梁爽刘济远赵君唐休发. 丝/苏氨酸蛋白激酶/哺乳动物雷帕霉素靶蛋白/p70 S6K信号通路在口腔鳞癌中的表达及临床意义[J]. 华西口腔医学杂志, 2014, 32(5): 504-508.
[10]	张静李纾吕琳琳. 失神经支配对牙周组织中P物质及破骨细胞的影响[J]. 华西口腔医学杂志, 2014, 32(2): 162-165.
[11]	冯燕康晓洁黎春晖聂敏海. 细胞角蛋白19和间隙连接蛋白43在4-亚基硝氧喹啉诱发大鼠舌黏膜癌变过程中表达的研究[J]. 华西口腔医学杂志, 2013, 31(3): 237-241.
[12]	孟贺丁洁李任梁锐英吴文慧. 4种牙科金属材料对成纤维细胞L929凋亡相关基因及蛋白表达的影响[J]. 华西口腔医学杂志, 2013, 31(3): 242-246.
[13]	刘争进殷平陈勇刚廖洪锋吕彦. 涎腺导管癌伴巨细胞瘤样改变1例[J]. 华西口腔医学杂志, 2013, 31(3): 317-319.
[14]	李欣忆段丁瑜王盼盼韩波徐屹. 人β防御素-4在牙龈组织表达的新发现[J]. 华西口腔医学杂志, 2013, 31(2): 165-168.
[15]	陈菲张庆庆陆东辉王三锡. 4例面颈部Castleman病的临床病理分析[J]. 华西口腔医学杂志, 2013, 31(1): 96-98.

颌面部颗粒细胞瘤临床病理及免疫组织化学分析

Clinicopathological and immunohistochemical analysis of maxillofacial granular cell tumor

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 24

相关文章 15

编辑推荐

Metrics

本文评价