头颈部小圆细胞恶性肿瘤临床特点分析(1)
摘要：目的 探討头颈部小圆细胞恶性肿瘤的临床、影像学、病理特点，为临床早期诊断提供理论依据。方法 回顾青岛大学附属医院耳鼻咽喉科2008年6月～2018年5月诊治的组织病理学特点为小圆细胞的恶性肿瘤290例患者的病历资料，总结其临床特点、影像学及病理特点。结果 ①头颈部小圆细胞恶性肿瘤主要好发于鼻腔、鼻窦、鼻咽及颅底区，耳及喉部极少见，可向颅内、眼眶等临近部位浸润，也可转移至颈部淋巴结或远处转移。临床症状以鼻塞、鼻出血、嗅觉减退等为主;②小细胞神经内分泌癌和非角化性癌以男性多见，恶性黑色素瘤和小细胞神经内分泌癌见于40岁以上的中老年人群。横纹肌肉瘤各年龄段均可发生;③所有肿瘤影像学上均可见软组织占位及骨质破坏，病理组织形态学均表现为分化差的小圆细胞肿瘤。结论 头颈部小圆细胞恶性肿瘤发病率低，其发病部位及症状无明显特异性，病理学形态、影像学及临床特征多无明显特异性，难以鉴别，容易误诊。目前免疫组织化学检测仍是小圆细胞恶性肿瘤确诊的主要方法，而此类疾病恶性程度较高、侵袭性强，往往确诊时病变范围已较大，影响治疗及预后，早期诊断早期治疗可以提高患者生存率。
, http://www.100md.com
关键词：小圆细胞恶性肿瘤;临床特点;早期诊断;病理特点
中图分类号：R730.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.05.045
文章编号：1006-1959(2019)05-0142-04
Abstract：Objective To investigate the clinical， imaging and pathological features of small round cell malignant tumors of the head and neck， and to provide theoretical basis for early clinical diagnosis. Methods The medical records of 290 patients with small round cell malignant tumors from June 2008 to May 2018 were reviewed. The clinical features， imaging and pathological features were summarized. Results ①Head and neck small round cell malignant tumors mainly occur in the nasal cavity， sinuses， nasopharynx and skull base area. The ear and throat are rare， and can be infiltrated into the vicinity of the skull， eyelids， etc.， and can also be transferred to the neck. Lymph nodes or distant metastases. Clinical symptoms include nasal congestion， nosebleeds， and olfactory dysfunction;②Small cell neuroendocrine carcinoma and non-keratinized carcinoma are more common in men， and malignant melanoma and small cell neuroendocrine carcinoma are found in middle-aged and elderly people over 40 years old. Rhabdomyosarcoma can occur in all ages; ③All tumors can be seen in soft tissue occupying and bone destruction， andhistopathological morphology is characterized by poorly differentiated small round cell tumors. Conclusion The incidence of small round cell malignant tumors in the head and neck is low， and the location and symptoms of the head and neck are not specific. The pathological morphology， imaging and clinical features are not specific， difficult to identify and easy to be misdiagnosed. At present， immunohistochemical detection is still the main method for the diagnosis of small round cell malignant tumors， and these diseases are highly malignant and invasive. The range of lesions is often diagnosed at the time of diagnosis， affecting treatment and prognosis. Early diagnosis and early treatment can improve patient survival rate., http://www.100md.com(石小红 姜彦 王琳)
, http://www.100md.com
关键词：小圆细胞恶性肿瘤;临床特点;早期诊断;病理特点
中图分类号：R730.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.05.045
文章编号：1006-1959(2019)05-0142-04
Abstract：Objective To investigate the clinical， imaging and pathological features of small round cell malignant tumors of the head and neck， and to provide theoretical basis for early clinical diagnosis. Methods The medical records of 290 patients with small round cell malignant tumors from June 2008 to May 2018 were reviewed. The clinical features， imaging and pathological features were summarized. Results ①Head and neck small round cell malignant tumors mainly occur in the nasal cavity， sinuses， nasopharynx and skull base area. The ear and throat are rare， and can be infiltrated into the vicinity of the skull， eyelids， etc.， and can also be transferred to the neck. Lymph nodes or distant metastases. Clinical symptoms include nasal congestion， nosebleeds， and olfactory dysfunction;②Small cell neuroendocrine carcinoma and non-keratinized carcinoma are more common in men， and malignant melanoma and small cell neuroendocrine carcinoma are found in middle-aged and elderly people over 40 years old. Rhabdomyosarcoma can occur in all ages; ③All tumors can be seen in soft tissue occupying and bone destruction， andhistopathological morphology is characterized by poorly differentiated small round cell tumors. Conclusion The incidence of small round cell malignant tumors in the head and neck is low， and the location and symptoms of the head and neck are not specific. The pathological morphology， imaging and clinical features are not specific， difficult to identify and easy to be misdiagnosed. At present， immunohistochemical detection is still the main method for the diagnosis of small round cell malignant tumors， and these diseases are highly malignant and invasive. The range of lesions is often diagnosed at the time of diagnosis， affecting treatment and prognosis. Early diagnosis and early treatment can improve patient survival rate., http://www.100md.com(石小红 姜彦 王琳)