Ide F, Mishima K, Yamada H, Saito I, Horie N, Shimoyama T, Kusama K
Department of Pathology, Tsurumi University School of Dental Medicine, Yokohama, Japan.
J Oral Pathol Med. 2008 Jan;37(1):43-9. doi: 10.1111/j.1600-0714.2007.00594.x.
Myopericytoma (MPC) is a generic denomination to describe tumors showing differentiation toward perivascular myoid cells /myopericytes. It has been suggested that MPC forms a morphologic continuum with glomus tumor (GT), solitary myofibroma (SMF), and angioleiomyoma (ALM). This proposed relationship has not yet been assessed in the oral region.
We reviewed our 28-year experience with 35 oral tumors, originally diagnosed as ALM (n = 28), SMF (n = 4), GT (n = 2), and MPC (n = 1) to analyze their overlapping microscopic features, with the assistance of immunohistochemistry.
Myopericytoma showed a wide range of growth patterns; concentric perivascular whorls, hemangiopericytomatous areas, glomangiopericytoma (GPC)-type vessels and leiomyomatous foci. Intravascular growth was also seen. Among 28 cases studied, three ALM were reclassified as MPC (n = 2) and SMF (n = 1), based on the present diagnostic criteria. Additional MPC-type components, at varying degrees, were similarly found in four ALM and three SMF, at least focally. One GT featured intravascular whorls of spindle cells. These four interrelated groups of tumors had in common GPC-type vasculature and intraluminal cellular proliferation was nearly ubiquitously present. Diffuse immunoreactivity for alpha-smooth muscle actin and less staining intensity of muscle-specific actin were observed in all tumors. Only ALM displayed desmin positivity of variable extent. Neither case tested expressed CD34.
Our data matches with the recent results in extraoral sites that MPC, GT, SMF, and ALM exhibit histologic and immunohistochemical overlap with each other. A common perivascular myoid differentiation between these tumor types is further reinforced by the present oral series.
肌周细胞瘤（MPC）是一个通用术语，用于描述向血管周围肌样细胞/肌周细胞分化的肿瘤。有人提出，MPC与血管球瘤（GT）、孤立性肌纤维瘤（SMF）和血管平滑肌瘤（ALM）形成形态学连续体。这种推测的关系尚未在口腔区域得到评估。
我们回顾了28年来对35例口腔肿瘤的经验，这些肿瘤最初被诊断为ALM（n = 28）、SMF（n = 4）、GT（n = 2）和MPC（n = 1），借助免疫组织化学分析它们重叠的微观特征。
肌周细胞瘤表现出广泛的生长模式；同心性血管周围漩涡、血管外皮细胞瘤样区域、血管球血管外皮细胞瘤（GPC）型血管和平滑肌瘤样灶。还可见血管内生长。在研究的28例病例中，根据目前的诊断标准，3例ALM被重新分类为MPC（n = 2）和SMF（n = 1）。另外，在4例ALM和3例SMF中至少局灶性地发现了不同程度的MPC型成分。1例GT具有梭形细胞的血管内漩涡。这四组相关肿瘤共同具有GPC型脉管系统，管腔内细胞增殖几乎普遍存在。在所有肿瘤中均观察到α-平滑肌肌动蛋白的弥漫性免疫反应，而肌肉特异性肌动蛋白的染色强度较低。只有ALM显示出不同程度的结蛋白阳性。所检测的病例均未表达CD34。
我们的数据与口腔外部位的最新结果相符，即MPC、GT、SMF和ALM在组织学和免疫组织化学上相互重叠。本口腔系列进一步强化了这些肿瘤类型之间常见的血管周围肌样分化。
