Vincenzi A, Rossi G, Monzani D, Longo L, Rivasi F
J Clin Pathol. 2002 Nov;55(11):872-5. doi: 10.1136/jcp.55.11.872.
A 72 year old woman presented complaining of nasal obstruction, rhinorrea, and epistaxis. At examination, a polypoid mass on the right posterior choana was revealed and subsequently removed. Light microscopic findings consisted of a diffuse proliferation of spindle shaped, pleomorphic cells with eosinophilic cytoplasm and blunt ended nuclei in a prominent myxoid background. The presence of numerous plurinucleate, bizarre cells made it very difficult to determine the malignant potential. Immunohistochemical evidence for leiomyogenic markers coupled with the low mitotic rate, the lack of an infiltrating growth pattern, and the indolent clinical course led to the diagnosis of atypical leiomyoma with prominent myxoid change. A literature survey confirmed that such a tumour is extremely rare at this site, but the biological behaviour seems to be similar to its uterine counterpart. Clinicians should be aware of this occurrence to prevent misdiagnosis because a conservative therapeutic approach is necessary in this disease.
一名72岁女性因鼻塞、鼻漏和鼻出血前来就诊。检查时发现右侧后鼻孔有一个息肉样肿物，随后将其切除。光镜检查结果显示，在显著的黏液样背景中，梭形、多形性细胞弥漫性增生，细胞质嗜酸性，细胞核钝圆。大量多核、奇异细胞的存在使得很难确定其恶性潜能。免疫组化显示平滑肌源性标志物阳性，同时有丝分裂率低、缺乏浸润性生长模式以及临床病程进展缓慢，最终诊断为伴有显著黏液样改变的非典型平滑肌瘤。文献调查证实，这种肿瘤在该部位极为罕见，但其生物学行为似乎与其子宫内的对应物相似。临床医生应了解这种情况以防止误诊，因为对于这种疾病采取保守治疗方法是必要的。
