原发性阑尾黏液腺癌临床病理分析  

Clinical pathological analysis of primary apendiceal mucinous adenocarcinoma

作　　者：马丽梅[1] 曾林华[1] 

机构地区：[1]自贡市第三人民医院病理科,四川自贡643020

出　　处：《现代医药卫生》2012年第21期3244-3245,共2页Journal of Modern Medicine & Health

摘　　要：目的探讨阑尾原发性黏液腺癌的组织发生、临床病理特点及免疫表型。方法运用组织形态学及免疫组化分析1例发生在阑尾的黏液腺癌转移至子宫、双侧附件及大网膜患者的病历资料,并结合文献进行分析。结果阑尾黏液腺癌形态学上表现为分化好的黏液上皮性病灶,上皮细胞立方或柱状,胞浆透亮,核位于基底部,核分裂象罕见,腺腔充满胶冻样黏液。免疫组化显示,肿瘤细胞CK(low MW),癌胚抗原(CEA)、上皮膜抗原(EMA)、广谱细胞角蛋白CK(pan)、C-erbB-2均为阳性,ki-67肿瘤细胞约70%阳性,CK7、S-100、Vimentin、CgA、Syn阴性。结论原发性阑尾黏液腺癌十分少见,至晚期广泛转移及双侧卵巢受累时,确定原发诊断较困难,根据其组织学改变、免疫组化鉴别诊断方可确诊。Objective To explore the histogenesis,clinicopathological features and immune phenotypes of primary appendiceal mucinous adenocarcinoma.Methods The clincal data in 1 case of appendiceal mucinous adenocarcinoma with metastasis to the uterus,bilateral annexes and the greater omentum were analyzed by the morphology and immunohistochemistry in combination with the literature review.Results The morphology of appendiceal mucinous adenocarcinoma is presented as the differentiated mucous epithelial lesions.The epithelial cell is cubic or cylindrical,and its cytoplasm is translucent,with the nuclear located at the base,and the mitotic phenomenon is rare.The glandular cavity is filled with jelly-like mucus.Immunohistochemistry shows that CK（Low MW）,CEA,EMA,CK（pan）,C-erbB-2 in tumor cells are all positive,and about 70% of ki-67 tumor cells are positive.CK7,S-100,Vimentin,CgA,Syn are negative.Conclusion Primary appendiceal mucinous adenocarcinoma is very rare.It is hard to determine the primary diagnosis until its wide metastasis to the bilateral ovarian at the late period.It can only be confirmed by analyzing its histological changes,the immunohistochemistry and the differential diagnosis.

关 键 词：阑尾肿瘤 黏液腺癌 原发性 

分 类 号：R735.36[医药卫生—肿瘤]