头颈部脂肪母细胞瘤 20 例临床病理分析。
Lipoblastoma Arising in the Head and Neck: A Clinicopathologic Analysis of 20 Cases.
机构信息
Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, Saudi Arabia.
Department of Pathology, Children's Hospital Boston and Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
出版信息
Head Neck Pathol. 2023 Sep;17(3):768-774. doi: 10.1007/s12105-023-01575-5. Epub 2023 Jul 24.
BACKGROUND
Lipoblastomas (LPBs) are benign adipocytic neoplasms believed to recapitulate the development of embryonal fat.
METHODS
We investigated the clinicopathologic and immunohistochemical features of 20 lipoblastomas arising in the head and neck in 18 patients.
RESULTS
Patients included 6 males and 12 females (1:2 ratio) with age at diagnosis ranging from 4 months to 28 years. Tumors occurred more commonly in the neck (12, 66.7%) and less commonly in the forehead, scalp, and tongue (2, 11.1%). Tumor size ranged from 1.4 to 6.0 cm (median 5.0 cm). Two patients, a 4-month-old female and 3-year-old male, had local recurrence of neck tumors at 4 months and 3 years after excision, respectively. Microscopically, tumors had a lobulated growth pattern and consisted of adipocytes at varying stages of differentiation. In addition to the classical histologic features, lipoma-like and myxoid variants constituted 45% of cases. Metaplastic elements, including brown fat and cartilage, were identified in two cases.
CONCLUSIONS
LPBs arising in the head and neck region are not uncommon and occurred at a rate of 9% in our cohort. They should be kept in the differential diagnosis when a fatty tumor is encountered in an older child or occurring at an unusual location.
背景
脂肪瘤（LPB）是良性脂肪细胞肿瘤，被认为是胚胎脂肪发育的再现。
方法
我们研究了 18 例患者的 20 例发生在头颈部的脂肪瘤的临床病理和免疫组织化学特征。
结果
患者包括 6 名男性和 12 名女性（1:2 比例），诊断时年龄从 4 个月到 28 岁不等。肿瘤更常见于颈部（12 例，66.7%），较少见于额部、头皮和舌部（2 例，11.1%）。肿瘤大小从 1.4 厘米到 6.0 厘米不等（中位数为 5.0 厘米）。2 例患者，分别为 4 个月大的女性和 3 岁的男性，在切除后 4 个月和 3 年后出现颈部肿瘤局部复发。显微镜下，肿瘤呈分叶状生长模式，由不同分化阶段的脂肪细胞组成。除了经典的组织学特征外，脂肪瘤样和黏液样变体占病例的 45%。两个病例中还存在包括棕色脂肪和软骨在内的化生成分。
结论
发生在头颈部的 LPB 并不罕见，在我们的队列中发生率为 9%。当遇到年龄较大的儿童或发生在不常见的部位的脂肪性肿瘤时，应将其纳入鉴别诊断。
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