鼻中隔肌上皮瘤：一例附影像学与病理学见解的病例报告

文献信息

中文摘要

背景： 肌上皮瘤是一种罕见的良性唾液腺肿瘤，占所有唾液腺肿瘤的<1%，英文文献中仅报道了十余例累及鼻腔或鼻旁窦的病例。由于其罕见性、缺乏特异性影像学特征以及与其它肿瘤存在显著的组织学重叠，其诊断对临床医生、放射科医生和病理科医生均构成挑战。方法：我们报告一例68岁男性，表现为6个月内进行性加重的鼻塞，最终诊断为鼻腔肌上皮瘤。结果：内镜下经鼻肿瘤切除术后约3个月，患者未见复发迹象。低细胞学异型性、低Ki-67增殖指数以及特征性免疫组化表现支持良性肌上皮瘤的诊断。结论：本病例提示，当在鼻腔或鼻旁窦观察到外观良性的肿瘤时，应将肌上皮瘤纳入鉴别诊断。整合影像学、组织病理学和免疫组化的多学科方法对于确立准确诊断至关重要。

英文摘要

Myoepithelioma is a rare benign salivary gland tumor, accounting for <1% of all salivary gland neoplasms, with only a little over ten cases of nasal cavity or paranasal sinus involvement reported in the English literature. Due to its rarity, lack of specific imaging features, and significant histological overlap with other tumors, the diagnosis poses a challenge for clinicians, radiologists, and pathologists. We present a case of a 68-year-old male with progressively worsening nasal obstruction over 6 months, ultimately diagnosed with nasal myoepithelioma. Approximately 3 months after endoscopic transnasal tumor resection, the patient showed no signs of recurrence. Low cytological atypia, a low Ki-67 proliferation index, and characteristic immunohistochemical findings support the diagnosis of benign myoepithelioma. This case suggests that myoepithelioma should be considered in the differential diagnosis when benign-appearing tumors are observed in the nasal cavity or paranasal sinuses. A multidisciplinary approach integrating imaging, histopathology, and immunohistochemistry is essential for establishing an accurate diagnosis.