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恶性颗粒肌母细胞瘤属少见的病例,据 Cadotte.报道,1974年以前世界上仅有14例。我国仅有临床资料报道,但未见完整病理资料报道。最近我院收治一例,现报告如下。患者,女,5岁(住院号:148154)。右背部无痛性肿块半月入院。查体:右肩胛骨角外下方约1.5×1.0×0.5 cm 肿物,临床诊断:右背部纤维瘤。在局麻下行手术切除。镜下所见肿瘤细胞大多呈多边形、圆形、椭圆形、边境较清楚.胞浆丰富、胞核小、深染、瘤细胞被纤维组织分隔成大小不一的巢状,索状。有些瘤细胞小,似与周围梭形细胞有形态过渡。瘤细胞排列成波浪状,与神经鞘细胞相似,可见瘤细胞广泛坏死区。瘤细胞大小不一,核大,核仁大、清楚,核分裂现象多见,瘤细胞内有嗜碱性颗粒。病理诊断:右背部恶性颗粒肌母细胞瘤。术后2个月原发切口处肿瘤复发而再次入院。查体:
Malignant granuloblastic tumors are rare cases, according to Cadotte. There were only 14 cases in the world before 1974. Only clinical data were reported in China, but no complete pathological data was reported. Recently, one case was admitted to our hospital. The report is as follows. Patient, female, 5 years old (Hospital number: 148154). The painless mass on the right back was admitted to the hospital half a month. Physical examination: A 1.5 x 1.0 x 0.5 cm mass below the right shoulder blade angle. Clinical diagnosis: Right back fibroids. Surgical removal under local anesthesia. Most of the tumor cells seen under the microscope are polygonal, round, oval, and the borders are clear. The cytoplasm is abundant, the nucleus is small, and the dark stains are stained. The tumor cells are separated into fibrous tissues to form nests of different sizes. Some tumor cells are small and appear to have a morphological transition with the surrounding spindle cells. The tumor cells are arranged in a wavy shape, similar to the nerve sheath cells, and the extensive necrosis area of the tumor cells can be seen. The tumor cells have different sizes, large nuclei, large nucleoli, clear and more common mitoses, and basophilic granules in tumor cells. Pathological diagnosis: Right back malignant granulosablastoma. Two months after the primary incision, the tumor recurred and was admitted again. Physical examination: