鼻腔鼻窦肠型腺癌1例并文献复习  

Sinonasal intestinal-type adenocarcinoma:report of one case and review of literature

作　　者：沈岚 薛秀芬 冯娜 陶静莉 郭培 裴小娟 SHEN Lan;XUE Xiu-fen;FENG Na;TAO Jing-li;GUO Pei;PEI Xiao-juan(Department of Pathology,Shenzhen Hospital of Southern Medical University,Shenzhen 518100,China;Department of Pathology,Donghua Hospital of Sun Yat-sen University,Dongguan 523413,China)

机构地区：[1]南方医科大学深圳医院病理科,广东深圳518100 [2]中山大学附属东华医院病理科,广东东莞523413

出　　处：《诊断病理学杂志》2022年第9期846-848,869,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨鼻腔鼻窦肠型腺癌的临床症状、病理特征、诊疗过程及预后。方法回顾分析1例确诊鼻腔鼻窦肠型腺癌的影像学、组织学、免疫组化,同时结合文献总结鼻腔鼻窦肠型腺癌病理诊断要点与预后的关系。结果肉眼观肿瘤组织比较破碎,低倍镜下,坏死及肉芽组织背景中,癌组织大部分呈乳头状生长,部分呈腺样及不规则管状生长,偶见巢状区域;高倍镜下,癌细胞中度异型,胞质嗜酸,空泡状及杆状核,核仁明显,核分裂象易见。免疫组化:癌细胞弥漫表达CDX2、Villin,强弱不等表达CK20,少量弱表达SATB2,不表达CK7和MUC2、Ki-67增殖指数约70%。结论鼻腔鼻窦肠型腺癌是一种罕见的发生于鼻腔鼻窦的非唾液型腺癌,早期鼻内镜手术切除患者预后较好,乳头状亚型相对其他组织学亚型预后较好。Objective To investigate the clinical symptoms,pathological features,diagnostic and prognosis of sinonasal intestinal-type adenocarcinoma.Methods Imaging data,morphology and immunohistochemistry were analyzed,combined with relevant literature to summary the pathological diagnosis keys and prognosis of sinonasal intestinal-type adenocarcinoma.Results Histopathology showed that in the context of necrotic and granulation tissue most of the lesion presented with papillary,partially glandular and irregular tubular growth patterns.The neoplastic cells were moderately differentiated with eosinophilic cytoplasm,prominent nucleoli and mitotic figures.Immunohistochemistry showed that both CDX-2 and villin were strongly positive,CK20 was positive,and SATB2 was weakly positive,while CK7 and MUC2 were negative.Conclusion Sinonasal intestinal-type adenocarcinoma is a rare malignant tumor that occurs in nasal cavities;early nasal intrachanoscopic resection and papillary subtype of the tumor have better prognosis.

关 键 词：鼻腔鼻窦肠型腺癌 组织学 免疫组化 预后 

分 类 号：R739.62[医药卫生—肿瘤]