肝脏和脾脏炎性假瘤样滤泡树突细胞肿瘤的临床病理分析

摘要

Objective To study the clinicopathological features and biological behavior of inflammatory pseudotumor-like follicular dendritic cell tumor.Methods We studied the clinical data,HE sections,immunohistochemical staining,Epstein-Barr virus encoded nuclear RNA(EBER)in situ hybridization and outcome of one patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver,and thirteen patients with inflammatory pseudotumor of liver and spleen treated at the Shengjing Hospital of China Medical University from 2001 to 2010.Results Among the thirteen inflammatory pseudotumors,we diagnosed 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of spleen and 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver using immuno-histochemical staining and EBER in situ by hybridization.The liver case had pathological morphology consistent with those described in the literatures,but the splenic case had specific histologic features.They were both female,and were alive 2.5 and 6 years after operation.Conclusions Inflammatory pseudotumor-like follicular dendritic cell tumor should be distinguished from inflammatory pseudotumor.It is a rare tumor seen mainly in liver and spleen.The diagnosis depends on histopathological and immunohistochemical findings.Inflammatory pseudotumor-like follicular dendritic cell tumor is a low-grade malignant tumor.Surgical excision is the treatment of choice.The two cases provided evidence for its indolent behavior.%目的 探讨炎性假瘤样滤泡树突细胞肿瘤的临床病理特征及生物学行为.方法 收集中国医科大学附属盛京医院病理科2001-2010年诊断为肝脏炎性假瘤样滤泡树突细胞肿瘤(1例)、肝脏和脾脏炎性假瘤病例(13例)资料、复查HE切片、进行免疫组化染色、EB病毒编码的核RNA(Epstein-Barr virus encoded nuclear RNA,EBER)原位杂交,并追踪患者预后.结果 免疫组化染色和EBER原位杂交证实,13例肝脏和脾脏炎性假瘤中有1例为脾脏炎性假瘤样滤泡树突细胞肿瘤,有特殊的组织学形态；1例肝脏炎性假瘤样滤泡树突细胞肿瘤则经进一步检查证实,其组织形态与文献报道一致.2例患者均为女性,术后分别随访2.5年、6年均健在.结论 炎性假瘤样滤泡树突细胞肿瘤应从炎性假瘤中分离出来,此病非常少见.该肿瘤主要发生于肝脏和脾脏,确诊依赖组织形态和免疫组化.其生物学行为相对惰性,属于低度恶性肿瘤,手术彻底切除是根本的治疗方法.本文2例为炎性假瘤样滤泡树突细胞肿瘤的相对惰性的生物学行为提供了进一步的证据.