喉神经内分泌癌3例报道及文献复习  

Laryngeal neuroendocrine carcinoma: a report of three cases with review of liter ature

作　　者：张哉根[1] 叶明福[1] 赵海兴[2] 刁鑫伟[1] 汤金梁[1] 王亚丽[1] 

机构地区：[1]第三军医大学新桥医院病理科,重庆400037 [2]解放军第324医院病理科,重庆400037

出　　处：《诊断病理学杂志》2005年第1期55-57,i016,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　报道 3例喉原发性神经内分泌癌 ,并探讨其病理学特征及其鉴别诊断。方法　对 3例喉神经内分泌癌进行光镜、电镜观察及免疫组化标记。结果　 3例肿瘤均位于声门上会咽区 ,大体直经 <3cm ,2例呈息肉状。光镜检查 2例肿瘤以巢团状结构为主 ,瘤细胞胞质丰富 ,嗜酸性 ,核分裂象易见 ,有坏死。 1例以小梁状结构为特征 ,瘤细胞较小 ,分裂象罕见 ,无坏死。免疫组化标记显示瘤细胞CgA、Syn、CK(AE1)及NSE(+) ,S 10 0、HMB4 5及GFAP(- )。电镜观察瘤细胞间有细胞连接复合体、细胞内腔及神经内分泌颗粒。结论　喉神经内分泌癌是少见的恶性肿瘤 ,形态学上应当与喉的低分化鳞癌、副节瘤、无色素性黑色素瘤等相鉴别。免疫组化标记及电镜观察对于鉴别诊断很有帮助。Objective To study the clinical pathological features and differential diagnosis of laryng eal neuroendocrine carcinoma (LNEC). Methods Three cases of LNEC were investigated by light micr oscopy, electron microscopy, and immunohistochemistry. Results Three cases of LNEC were located in the epiglottis. Gr ossly, tumor of 3 cases was <3?cm in diametar. 2 cases among them showed polypo id mass. Microscopically, the tumor was composed of cells with abundant esinophilic cytoplasm arranged in neets,and mitotic figures, and necrosis were e asily identified in 2 cases. One case was characterized by trabecular patten with ra re mitosis an d without necrosis. Immunohistochemically, tumor cells were stained positively f or CgA, N SE, Syn and CK (AE1), but negatively for S-100 protein, HMB45, and GFAP. Ultras tructura lly, the neurosecretory granules with small number were obversed in the cytoplas m of atypical carcinoid. Cellular junctional complexes and intercellular lumina we re present.Conclusion LNEC is a rare malignant tumor with complex morphology. It is necessary to diffe r entiate from poorly differentiated squamous cell carcinoma, laryngeal paragangl i oma, amelanotic melanoma etc, morphologically. Immunohistochemistral and electro n microscopic technique are very useful for the diagnosis.

关 键 词：神经内分泌癌 免疫组织化学 电镜检查 病理学诊断 

分 类 号：R739.65[医药卫生—肿瘤]