Resta L, Pennella A, Fiore M G, Botticella M A
Istituto di Anatomia e Istologia Patologica, Piazza Giulio Cesare, Policlinico, Bari, Italy.
Eur Arch Otorhinolaryngol. 2000;257(5):260-2. doi: 10.1007/s004050050235.
A few cases of malignant fibrous histiocytoma (MFH) of the larynx have been reported to date. All ages may be affected, but the tumor is more prevalent in the sixth and seventh decade of life. We describe a case of MFH in a 71-year-old Italian man who 8 years before underwent a right cordectomy and radiotherapy for squamous cell carcinoma. Recurrent tumor was found to be MFH. The clinico-pathological features of this tumor are presented and the possible relationship between radiotherapy and MFH discussed. The neoplasm was characterized by spindle-shaped atypical cells arranged in a diffuse storiform pattern. Mitoses were prominent, numerous, and often atypical. Immunohistochemically, neoplastic cells were strongly positive for vimentin and alpha1-antichymotrypsin but were negative for cytokeratins and S-100 protein. These findings confirmed the diagnosis and excluded possible sarcomatoid carcinoma, inflammatory pseudotumor, and a new carcinosarcoma. The risk of sarcoma after radiotherapy for squamous cell carcinoma in the larynx is very low when considering the frequent use of radiotherapy, but long follow-ups are required.
迄今为止，已有数例喉恶性纤维组织细胞瘤（MFH）的病例报道。各年龄段均可发病，但该肿瘤在60至70岁人群中更为常见。我们报告一例71岁意大利男性的MFH病例，该患者8年前因鳞状细胞癌接受了右侧声带切除术及放疗。复发肿瘤经诊断为MFH。本文介绍了该肿瘤的临床病理特征，并讨论了放疗与MFH之间可能存在的关系。肿瘤的特征为梭形非典型细胞呈弥漫性车辐状排列。核分裂象显著、数量众多且常为非典型性。免疫组化显示，肿瘤细胞波形蛋白和α1-抗糜蛋白酶呈强阳性，但细胞角蛋白和S-100蛋白呈阴性。这些结果证实了诊断，并排除了可能的肉瘤样癌、炎性假瘤及新发生的癌肉瘤。考虑到放疗的广泛应用，喉鳞状细胞癌放疗后发生肉瘤的风险非常低，但仍需要长期随访。
