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Polypoid Laryngeal Inflammatory Myofibroblastic Tumors: Misleading Lesions: Description of Six Cases Showing ALK Overexpression.

易误诊的喉息肉状炎性肌纤维母细胞瘤:6例显示ALK过表达的病例报道

Pierry C,Pérot G,Karanian-Philippe M,Neuville A,Gomez-Brouchet A,Crestani S,Coindre JM

Abstract

Laryngeal inflammatory myofibroblastic tumors (IMTs) are rarely reported in the literature but may be underrecognized. To better characterize their features, we report a series of six cases.
The clinicopathologic findings, including immunohistochemistry, fluorescence in situ hybridization (FISH) analysis, and follow-up, were evaluated and a review of the literature was performed.
These cases presented as small polypoid vocal cord or ventricular band lesions, with a more advanced mean age at diagnosis (49 years) than typically reported in other localizations. Apart from one secondary revision surgery, no complementary treatment and no recurrences were observed. Histologically, various morphologic features were seen. All tumors were spindle cell proliferations on a myxoid background with more or less atypia and significant inflammatory infiltrate. All six cases showed anaplastic lymphoma kinase (ALK) immunohistochemical expression. FISH rearrangement was present in four of six cases. Only two cases were initially diagnosed as IMT.
According to our series, laryngeal IMTs are easily misdiagnosed. They have a good prognosis, and ALK immunohistochemistry should be carried out to assess this diagnosis when spindle cell proliferations are observed in this localization.

摘要

喉炎性肌纤维母细胞瘤(IMT)文献中报道较少,可能是未被正确认识。为了更好地了解其病变特征,我们报道了6例病例。分析其临床病理检查结果,包括免疫组化、荧光原位杂交(FISH)分析和随访资料并进行文献复习。

这些病例表现为声带或室带小息肉样病变,与其他部位报道的典型病例相比,诊断时平均年龄(49岁)较大。除了1例进行二次手术外,无补充治疗和复发病例报道。组织学上,可见不同的形态学特征。所有肿瘤表现为黏液样背景中轻度或中度异型梭形细胞增生,伴有显著炎细胞浸润。所有6例免疫组化显示间变性淋巴瘤激酶(ALK)阳性。FISH检测显示其中4例出现重排。只有2例最初诊断为IMT。

根据本文报道和文献复习,喉IMT易误诊。该肿瘤预后良好,对这个部位梭形细胞增生性病变应进行ALK免疫组化染色以明确诊断。

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