Shek A W, Wu P C, Samman N
Department of Pathology, University of Hong Kong.
J Clin Pathol. 1996 Feb;49(2):164-7. doi: 10.1136/jcp.49.2.164.
To describe the clinicopathological and immunophenotypical findings of two cases of inflammatory pseudotumour in the oral cavity.
The patients presented with a short history of swelling in the cheek and the maxilla respectively. Magnetic resonance imaging or computerised tomography scan showed space occupying lesions with infiltrative margins which were interpreted as aggressive malignant neoplasms. Histological examination showed fascicles of spindle cells in a background of chronic reactive inflammatory cells including plasma cells, typical of inflammatory pseudotumour. The spindle cells were positive for vimentin, smooth muscle actin and CD68, but were negative for follicular dendritic cell markers. The lymphocytes showed no light chain restriction.
Inflammatory pseudotumour in the oral cavity is completely benign and simple excision is curative. However, it may be confused with a malignant tumour on clinical and radiographic grounds, and histologically the appearances can also be misinterpreted as those of a more aggressive lesion. Its correct recognition by the surgical pathologist is important to avoid unnecessarily radical and potentially mutilating surgery.
描述两例口腔炎性假瘤的临床病理及免疫表型特征。
两名患者分别表现为面颊部和上颌骨肿胀病史较短。磁共振成像或计算机断层扫描显示占位性病变,边界浸润,被解释为侵袭性恶性肿瘤。组织学检查显示在包括浆细胞在内的慢性反应性炎症细胞背景中有梭形细胞束,这是炎性假瘤的典型表现。梭形细胞波形蛋白、平滑肌肌动蛋白和CD68呈阳性,但滤泡树突状细胞标志物呈阴性。淋巴细胞无轻链限制。
口腔炎性假瘤完全良性,单纯切除可治愈。然而,基于临床和影像学表现它可能与恶性肿瘤混淆,并且在组织学上其表现也可能被误判为更具侵袭性的病变。手术病理学家正确识别它对于避免不必要的根治性和潜在致残性手术很重要。