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为了探讨颅底、鼻腔上皮样血管内皮细胞瘤(EH)的临床、影像及病理学特点,结合文献回顾性分析2例颅底鼻腔EH患者的诊断和治疗。该病病因不清,临床症状少且轻微,无特征性。影像学主要表现为不规则占位影,侵袭性生长,血供丰富。病理学上肿瘤呈结节状分布,细胞形态以上皮样或梭形细胞为主,瘤细胞胞质丰富,呈巢团状不规则排列,结节周边细胞较丰富,间质黏液变。瘤细胞一般缺乏多形性,核分裂及坏死少见。免疫组化显示,CD31、CD34阳性,广谱CK偶见灶性阳性,其他抗体阴性。初步研究结果提示,颅底鼻腔EH为一种上皮样血管内皮细胞分化的低度恶性肿瘤,具有独特病理学特征,临床及影像学特征不明显,容易误诊,需要引起重视,组织病理学是确诊关键。
In order to explore the clinical, imaging and pathological characteristics of skull base and nasal epithelial hemangioendothelioma (EH), two cases of skull base nasal EH were diagnosed and treated retrospectively. The etiology of the disease is unclear, clinical symptoms and minor, no characteristic. Imaging mainly for irregular occupying shadow, invasive growth, rich in blood supply. Pathological tumor showed nodular distribution, cell morphology to epithelial or spindle-shaped cells, tumor cells rich in cytoplasm, irregular clusters were clustered nest, nodular cells around the rich, interstitial mucus change. Tumor cells generally lack pleomorphism, mitosis and necrosis rare. Immunohistochemistry showed that CD31, CD34 positive, broad-spectrum CK occasionally foci positive, other antibodies negative. Preliminary results suggest that the skull base nasal EH is an epithelial-like vascular endothelial cell differentiation of low-grade malignant tumor has a unique pathological features, clinical and imaging features is not obvious, easily misdiagnosed, need attention, histopathology is diagnosed The essential.