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鼻腔鼻窦小圆蓝细胞肿瘤:病理学家的灰色地带

英文原题:The Small Round Blue Cell Tumors of Sinonasal Tract: Pathologists Grey Zone.

PubMed 2022/02/04(内容时间) J Microsc Ultrastruct

研究概要

鼻腔鼻窦道的肿瘤非常多样,在小圆细胞肿瘤中更是如此,后者表现为未分化形态。因此,准确诊断需要临床影像学参数以及特殊辅助技术,如IHC和分子研究,除组织病理学外,以便早期诊断和治疗,防止这些肿瘤引起的显著发病率和死亡率。

研究思路结论见上方概要

在鼻腔鼻窦区域,最具挑战性的诊断类别之一包括小蓝圆细胞肿瘤。这些恶性肿瘤在组织形态学和免疫组织化学(IHC)方面表现出许多重叠的发现。这些不完全可切除肿瘤的有限小活检增加了诊断的困惑。

在三级医疗中心进行了为期2年(2018年1月至2020年12月)的横断面研究,共纳入70例肿瘤病例,其中49例为恶性。所有石蜡包埋块均进行苏木精-伊红染色和IHC,必要时进行分子研究。

在全部病例中,小蓝圆细胞肿瘤构成主要类别,包括20例罕见且有趣的病例,其中有鼻窦未分化癌(4例)、恶性淋巴瘤(2例弥漫大B细胞淋巴瘤和2例结外NK/T细胞淋巴瘤)、横纹肌肉瘤(2例)、嗅神经母细胞瘤(2例)、恶性黑色素瘤(2例)、浆细胞瘤(2例)、非典型Ewing肉瘤(EWS)(1例)、EWS(1例)、睾丸核蛋白(NUT)癌(1例)和小细胞神经内分泌癌(1例)。

展开英文摘要原文

BACKGROUND: One of the most challenging diagnostic categories in the sinonasal tract includes small-blue-round-cell tumors. These are malignant tumors which show many overlapping histomorphology and immunohistochemistry (IHC) findings. Limited, small biopsy of these not completely excisable tumors adds to the diagnostic confusion. MATERIALS AND METHODS: A cross-sectional study was done for 2 years (January 2018-December 2020) in a tertiary care institute, which included 70 cases of tumors of which 49 cases were malignant. All paraffin-embedded blocks were subjected to hematoxylin and eosin stain and IHC followed by molecular study wherever needed. RESULTS: Of the total cases, small-blue-round-cell tumor constituted the major category comprising 20 rare and interesting cases which included sinonasal undifferentiated carcinoma (4 cases), malignant lymphoma (2 cases of diffuse large B-cell lymphoma and 2 cases of extranodal natural killer/T-cell lymphoma), rhabdomyosarcoma (2 cases), olfactory neuroblastoma (2 cases), malignant melanoma (2 cases), plasmacytoma (2 cases), atypical Ewing's sarcoma (EWS) (1 case), EWS (1 case), nuclear protein in testis (NUT) carcinoma (1 case), and small-cell neuroendocrine carcinoma (1 case). CONCLUSION: Tumors of the sinonasal tract are very diverse, more so in small-round-cell tumor which present with a undifferentiated morphology. Thus, accurate diagnosis needs clinicoradiological parameters and special ancillary techniques such as IHC and molecular study in addition to histopathology for early diagnosis and therapy to prevent significant morbidity and mortality caused in these tumors.

论文信息

作者
Mohapatra D、Sahoo N、Dehuri P、Das P、Mohapatra AS、Govardhan T
单位
Department of Pathology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.India
期刊
Journal of microscopy and ultrastructure2024 Jan-Mar
原文标识
PubMed 38633570 · DOI 10.4103/jmau.jmau_70_21