恶性造釉细胞瘤和造釉细胞癌的病理学研究

为探讨恶性造釉细胞瘤和造釉细胞癌的临床病理特点，及两个名称的自然历史和意义，我们对２４例恶性造釉细胞瘤（造釉细胞癌）的临床病理资料进行了研究，并对两个名称各自的实质进行了探讨。结果：其组织病理特点为滤泡周边细胞增生，可呈乳头状突向间质，核增大中度异型，核深染或呈空泡状，核分裂相增加，星网状细胞消失被肉瘤样细胞取代。其中１９例５～３０年随访结果为：１１例生存；３例１次复发，３例２次复发（其中１例复发后死亡），１例４次复发后死亡，１例１３年无复发死于它病。结果提示：“恶性造釉细胞瘤”这一名称更为科学。

Ameloblastic carcinoma and malignant amelobastoma: histological reunderstanding

Twenty four cases of malignant ameloblastoma were reported, among them were nineteen cases followed up for 5 to 30 years. Histologic characteristics include predominated proliferation of the peripheral cells with papillary protruding to stroma, replacement of the stellate reticular cells in the follicular center by sarcomatous cells, as well as large and deep stained or alveolar nuclei with moderate atypia, and high mitosis of the tumor cells. Clinico radiologically, the tumor showed malignant features such as fast growing recently, pain, anesthesia, cauliflower ulcer, limited mouth opening, and large multilocular radiolucent area with ill defined border. The biological behavior, nomenclature of the ameloblastic carcinoma or malignant ameloblastoma, and differential diagnosis from other tumors were also discussed.