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肾上腺外周围神经母细胞瘤:18例临床病理研究

Extra-adrenal peripheral neuroblastic tumors: A clinicopathological study of 18 cases.

作者信息

Shankaralingappa Sunitha, Patra Sanjiban, Gami Amisha, Trivedi Priti, Chalaliya Akshay Kumar

机构信息

Department of Oncopathology, The Gujarat Cancer, and Research Institute, Ahmedabad, Gujarat, India.

Department of Radiology, The Gujarat Cancer, and Research Institute, Ahmedabad, Gujarat, India.

出版信息

Indian J Pathol Microbiol. 2023 Apr-Jun;66(2):278-285. doi: 10.4103/ijpm.ijpm_362_21.

Abstract

BACKGROUND

Peripheral neuroblastic tumors arise from the sympathoadrenal lineage of the neural crest. They have been classified according to the International Neuroblastoma Pathology Committee (INPC) into Four categories according to International Neuroblastoma Pathology Committee (INPC): a) Neuroblastoma (NB) b) Ganglioneuroblastoma (GNB), nodular c) Ganglioneuroblastoma, intermixed, and d) Ganglioneuroma (GN). Because of the rarity of extra-adrenal peripheral neuroblastic tumors, limited information is available regarding the chemotherapy of NB and GNB. A few case reports or case series with a small number of patients have been documented in the literature.

AIM

To describe the clinicopathological characteristics of extra-adrenal peripheral neuroblastic tumors. Materials and.

METHODS

Clinical, histopathological, and immunohistochemistry (IHC) findings of 18 cases were retrieved. Immunohistochemistry at the time of diagnosis was performed using Ventana Benchmark XT. The mean value was calculated using the Microsoft Office Excel 2019 software.

RESULTS

The posterior mediastinum was the most commonly affected extra-adrenal site in our study. Neuroblastoma consisted of eight cases (six in children, two in adults), of which four cases were poorly differentiated and the other four cases were differentiating. Two cases had favorable histology. The bone marrow and cervical lymph node metastasis were documented. Of the four GNB cases, one patient developed bone metastasis. All patients of NB and GNB received combination chemotherapy. One out of six GN patients presented with a large retroperitoneal mass encasing the aorta and renal vessels, mimicking a sarcoma.

CONCLUSION

Extra-adrenal peripheral neuroblastic tumors do not pose any diagnostic issue in adequate tissue sampling. In limited material, immunohistochemistry is needed. The chemotherapy regimen has not been standardized due to rarity. Further molecular testing and targeted therapy may be of help in the future.

摘要

背景

外周神经母细胞瘤起源于神经嵴的交感肾上腺谱系。根据国际神经母细胞瘤病理委员会(INPC),它们被分为四类:a)神经母细胞瘤(NB);b)结节性神经节神经母细胞瘤(GNB);c)混合型神经节神经母细胞瘤;d)神经节瘤(GN)。由于肾上腺外外周神经母细胞瘤罕见,关于NB和GNB化疗的信息有限。文献中记录了一些少数患者的病例报告或病例系列。

目的

描述肾上腺外外周神经母细胞瘤的临床病理特征。材料与……

方法

检索18例患者的临床、组织病理学和免疫组织化学(IHC)结果。诊断时使用Ventana Benchmark XT进行免疫组织化学检测。使用Microsoft Office Excel 2019软件计算平均值。

结果

在我们的研究中,后纵隔是最常受累的肾上腺外部位。神经母细胞瘤有8例(儿童6例,成人2例),其中4例分化差,另外4例正在分化。2例组织学表现良好。记录有骨髓和颈部淋巴结转移。在4例GNB病例中,1例患者发生骨转移。所有NB和GNB患者均接受联合化疗。6例GN患者中有1例表现为巨大的腹膜后肿块,包绕主动脉和肾血管,类似肉瘤。

结论

肾上腺外外周神经母细胞瘤在足够的组织取样时不存在任何诊断问题。在材料有限时,需要进行免疫组织化学检测。由于罕见,化疗方案尚未标准化。未来进一步的分子检测和靶向治疗可能会有所帮助。

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