Zarbo Richard J, Marunick Mark T, Johns Robert
Department of Pathology, Henry Ford Hospital, Detroit, MI 48202, USA.
Arch Pathol Lab Med. 2003 Mar;127(3):352-5. doi: 10.5858/2003-127-0352-MASCV.
In this report, we document the histologic and clinical features of a previously undefined spindle cell variant of ameloblastoma that eventually behaved in a malignant fashion during a protracted course. The predominant histologic pattern was a well-differentiated, cellular, spindled epithelial proliferation arising in the maxilla of a 14-year-old African American girl. Over 19 years, the patient experienced numerous local recurrences, metastases to distant bones after 15 years, and finally bulky local recurrence with intracranial extension resulting in death. This ameloblastic malignancy histologically simulates a low-grade true sarcoma or an ameloblastic sarcoma, but differs in that the extensive spindle cell proliferation is epithelial, characterized by strong cytokeratin immunoreactivity and negative vimentin staining.
在本报告中，我们记录了一种先前未明确的成釉细胞瘤梭形细胞变体的组织学和临床特征，该变体在病程迁延期间最终表现为恶性。主要组织学模式为一名14岁非裔美国女孩上颌骨中出现的分化良好、细胞丰富的梭形上皮增生。在19年的时间里，患者经历了多次局部复发，15年后出现远处骨转移，最终局部复发肿块伴颅内扩展导致死亡。这种成釉细胞性恶性肿瘤在组织学上模拟低度真性肉瘤或成釉细胞肉瘤，但不同之处在于广泛的梭形细胞增生是上皮性的，其特征为细胞角蛋白免疫反应性强和波形蛋白染色阴性。
