Mao Rong-jun, Zhong Yan-ping, Peng Guo-guang, Fang Hui-qiong, Li Qi-ming
Department of Pathology, Guangzhou University of Chinese Medicine, Foshan, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Aug;46(8):681-3.
To investigate the clinicopathological features of multiple mucosal neuromas without multiple endocrine neoplasia type IIB (non-MEN-IIB MMN).
Three cases of non-MEN-IIB MMNs were analyzed for the clinical manifestations and histopathological characteristics.
All the 3 cases were females, age ranging from 30 to 45 years. Two cases of them involved in the laryngopharyngeal mucosa and another one located in the left margin of the tongue. Clinically, non-MEN-IIB MMNs presented with uncertain foreign body sensation, itching, vomiting and causalgia in the laryngopharyngeal areas. Mucosal papular lesions were treated by laser ablation or local surgical excision. The cases were respectively followed up for 6 to 20 months and found nothing. Histological examination showed the lesions were not encapsulated and contained irregular tortuous nerve bundles with undefined perineurium in the lamina propria. There were no nuclear palisade. Immunophenotype showed tumor cells strongly positive for vimentin, S-100, myelin specific enolase, CD56, neurofilament and neuron specific enolase, uniformly negative to CD34, CD117 and epithelial membrane antigen.
Non-MEN-IIB MMN is a very rare disease and the possibility of MEN-IIB should be excluded before making diagnosis. The lesions located in the mucosal tissue with polyp-like or papular appearance, so they should be differentiated from other neoplasms or non-neoplastic lesions.
探讨无多发性内分泌瘤2B型(非MEN-IIB型)的多发性黏膜神经瘤的临床病理特征。
分析3例非MEN-IIB型多发性黏膜神经瘤的临床表现及组织病理学特征。
3例均为女性,年龄30~45岁。其中2例累及喉咽黏膜,另1例位于舌左侧缘。临床上,非MEN-IIB型多发性黏膜神经瘤在喉咽区域表现为异物感不确切、瘙痒、呕吐及灼痛。黏膜丘疹样病变采用激光消融或局部手术切除治疗。分别随访6~20个月,未见异常。组织学检查显示病变无包膜,固有层内有不规则迂曲的神经束,神经束膜不明确。无核栅栏状排列。免疫表型显示肿瘤细胞波形蛋白、S-100、髓鞘特异性烯醇化酶、CD56、神经丝和神经元特异性烯醇化酶呈强阳性,对CD34、CD117和上皮膜抗原均呈阴性。
非MEN-IIB型多发性黏膜神经瘤是一种非常罕见的疾病,诊断前应排除MEN-IIB型的可能。病变位于黏膜组织,呈息肉样或丘疹样外观,故应与其他肿瘤或非肿瘤性病变相鉴别。