成人鼻腔鼻窦上皮样错构瘤分为浆液黏液腺错构瘤(seromucinous hamartoma，SMH)或呼吸道上皮腺瘤样错构瘤(respiratory epithelial adenomatoid hamartoma，REAH)。我们在此描述的是一种含有嗅上皮特征的成人鼻腔鼻窦错构瘤新亚型，这种组织学特征在既往文献中尚未报道。我们回顾性地收集了本科室数据库内含有嗅上皮特征的鼻腔鼻窦错构瘤病例。共收集到6例相关病例（3例男性患者和3例女性患者，年龄30～77岁），并对相应的病理切片和临床及影像学资料进行回顾性分析。其中5例发生在鼻嗅裂，为单侧、带蒂息肉状，长38～80mm。第6例与双侧鼻息肉相关，其发生部位尚不明确。所有患者均经鼻内窥镜手术治疗。其中得到充分随访的3例患者均未复发。从组织学上看，所有病变与SMH或REAH相似，所有含有嗅上皮特征的病例均由嗅神经细胞、支持细胞和基底细胞组成。在病灶表面或内陷的腺样结构中可以观察到嗅上皮，并可见到一种丝状聚合物。在一些病变处的的浆液黏液性腺体内也可见嗅觉受体细胞或细胞突起结构。嗅神经细胞表达CD56(神经细胞粘附分子），丝状聚合物表达CD56、神经纤维细丝蛋白和突触素。除SMH和REAH外，我们描述了成人鼻腔鼻窦错构瘤的第3种亚型—嗅觉上皮细胞错构瘤—其与另外2种错构瘤具有相同的良性特征。
Am J Surg Pathol 2018;42:9-17
美国外科病理学杂志中文版2018年第二期摘要No.5
李烨 翻译 邱雪杉 审校
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