十大需仔细观察的梭形头颈部病变。
Top 10 Significant Spindled Head and Neck Lesions to Scrutinze.
机构信息
Department of Pathology, University of Michigan Medical School, 3308 Rogel Cancer Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48103, USA.
出版信息
Head Neck Pathol. 2023 Mar;17(1):132-142. doi: 10.1007/s12105-023-01535-z. Epub 2023 Mar 16.
BACKGROUND
Spindled lesions are a challenging area in head and neck pathology. This is particularly true in the sinonasal tract, where several uncommon entities with both unique and overlapping morphologic, immunophenotypic, and/or molecular features can occur.
METHODS
Review.
RESULTS
The clinicopathologic characteristics of biphenotypic sinonasal sarcoma and nine important differential diagnostic considerations with one or more overlapping feature are summarized to establish a practical framework for approaching spindled lesions of the sinonasal tract.
CONCLUSION
Morphologic evaluation is central to the work up of sinonasal spindle cell lesions-in particular, cellular morphology, tumor architecture and growth pattern, and the presence of admixed epithelial elements - however, focused immunohistochemical analysis of neural, myogenic, rhabdomyoblastic, epithelial, and/or melanocytic marker expression and/or ancillary tests for tumor-specific molecular alterations may be necessary for definitive diagnosis.
背景
梭形细胞病变是头颈部病理学中的一个具有挑战性的领域。在鼻-鼻窦腔中尤其如此，这里有几种罕见的病变，它们具有独特的和重叠的形态学、免疫表型和/或分子特征。
方法
回顾。
结果
总结了双表型鼻-鼻窦肉瘤的临床病理特征以及九个重要的鉴别诊断考虑因素，其中一个或多个具有重叠特征，为鼻-鼻窦腔梭形细胞病变的处理建立了一个实用的框架。
结论
形态学评估是鼻-鼻窦梭形细胞病变的核心，特别是细胞形态、肿瘤结构和生长模式，以及混合上皮成分的存在，然而，对神经、肌源性、横纹肌样、上皮和/或黑色素细胞标记物表达的集中免疫组织化学分析，以及针对肿瘤特异性分子改变的辅助检测，可能是明确诊断所必需的。
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