原发性肺涎腺肿瘤临床病理特点  

Pathological features of primary pulmonary salivary gland tumor of the lung

作　　者：陆鸣[1] 柳玮华[1] 

机构地区：[1]首都医科大学附属北京友谊医院病理科,北京100050

出　　处：《心肺血管病杂志》2011年第5期420-423,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结一组原发性肺涎腺肿瘤临床病理和免疫组化特点,讨论其诊断和鉴别诊断。方法:对13例原发性肺涎腺肿瘤行苏木精-伊红(HE)染色和免疫组化标记。与26例原发性肺腺癌组织芯片标记结果对照。结果:肿瘤大体类型:1例发生于气管,11例发生于近段较大支气管。其中1例为支气管腔内息肉状生长,未侵及支气管软骨;8例肿瘤部分呈息肉状突入支气管腔内,部分侵及周围肺组织;2例肿瘤中见残留透明软骨或涎腺组织,提示肿瘤与较大支气管有关。只1例肿瘤与支气管无明确关系。肿瘤组织学类型:黏液表皮样癌7例、腺样囊性癌3例、腺泡细胞癌2例、多形性腺瘤内癌1例。免疫组化结果:肿瘤组:13例(100%)表达CK17和34βE12;12例(92%)表达CK7;10例(77%)表达S-100;9例(69%)表达P63;表达actin和PSA各3例;表达TTF-1和GCDFP-15各1例。CK20和ER均为阴性。对照组:CK17、P63和34βE12阳性表达为2例(8%)、5例(19%)和18例(69%)。actin、S-100、GCDFP-15、PSA均为阴性。而TTF-1则22例(85%)阳性。结论:CK17、S-100和P63是鉴别肺涎腺型癌有用的抗体,结合标记TTF-1有助于与非特异性肺腺癌的鉴别诊断。Objective：To summarize the clinic pathologic features of primary salivary tumors of the lung,and to discuss its diagnoses.Methods：Histopathologic features and immunohistochemical findings of 13 cases pulmonary primary salivary carcinoma were observed and compared to the result of 26 cases pulmonary adenocarcinoma tissue array.Results： In one patient the tumor arising in the trachea.In another one patient the tumor presented as polypoid endobronchial lesions obstructing the lobular lumen but no infiltrating to bronchial cartilages.Other eight patients the lesions were found in close proximity or in continuity with a bronchus;in two patients,the relationship to the bronchus could not be determined,but the bronchial cartilages or salivary acini could be seen in the tumors.And only one patient,the lesion presented as peripheral parenchymatous nodules unrelated to a bronchus.Histopathological type includes 7 cases mucoepidermoid carcinoma,3 cases adenoid cystic carcinoma,two cases acinic cell carcinoma,one case carcinoma-ex-pleomorphic adenoma.Immunohistochemical studies showed all 13（100%） cases of the primary pulmonary salivary-type carcinoma reacted for CK17 and 34βE12,12 of 13（92%）cases for CK7,10 of 13（77%）cases for S-100,9 of 13（69%） case for P63,3 of 13（23%）cases each for actin and PSA,1 of 13（8%） cases each for TTF-1 and GCDFP-15.Negative expression for CK20 and ER was observed in this group of cases.In the control group,expression of CK17、P63 and 34βE12 was 2（8%） cases、5（19%）cases and18（69%）cases respectively.Negative expsession for actin,S-100,GCDFP-15 and PSA.Otherwise 22（85%） cases positive for TTF-1.Conclusion： CK17,S-100 and P63 are useful markers for diagnosis of the primary pulmonary salivary-type carcinoma,and immunohistochemistry using a combination of TTF-1 may be of greater benefit in aiding the differential diagnoses with the pulmonary adenocarcinomas not otherwise specified（NOS）

关 键 词：肺肿瘤 黏液表皮样癌 免疫组化 病理特点 肺疾病 

分 类 号：R56[医药卫生—呼吸系统]