腮腺硬化性多囊性腺病临床病理观察  

Sclerosing polycystic adenosis of parotid gland: one case report and review of literature

作　　者：洪良利[1] 秦杰升[2] 黄杰雄[1] 邱前程[1] 

机构地区：[1]汕头大学医学院第一附属医院病理科,广东汕头515041 [2]汕头大学医学院第一附属医院耳鼻喉头颈外科,广东汕头515041

出　　处：《诊断病理学杂志》2013年第10期611-614,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨涎腺硬化性多囊性腺病(SPA)的临床及病理形态特征、诊断和鉴别诊断。方法对1例SPA进行临床、组织学形态和免疫组化染色观察,并文献复习。结果 SPA临床主要表现为腮腺区缓慢生长的无痛性肿块。组织学结构与乳腺纤维囊性病相似,表现为不规则的导管及腺泡分布于丰富的硬化性胶原间质中,形成模糊的小叶结构;腺上皮细胞形态多样,局部导管上皮增生伴轻度非典型性。免疫组化显示腺上皮EMA弥漫强(+),c-erbB2中度(+),CEA、ER、PR局灶(+),CD68(-);导管及腺泡周围肌上皮连续SMA和S-100(+);Ki-67增殖指数<1%。结论硬化性多囊性腺病是一种具有独特病理形态学特征的罕见涎腺疾病,需要与慢性硬化性涎腺炎等其他涎腺病变鉴别。Objective To explore the clinicopathologic features and diagnosis and differential diagnosis of sclerosing polycystic adenosis （SPA） of salivary gland. Methods One case of sclerosing polycystie adenosis was reported. The clinical data, pathological and features of this disease were reviewed and discussed with the relevant hterature. Results The common clinical symptom of SPA was a slowly growing painless mass in parotid gland region. It was morphologically similar to fibrocystic disease of the breast, with an abundant sclerotic collagenous stroma, permeated by ductal and acinar lobules. Some of the duct showed hyperplastic epithelia with mild atypia. Immunohistochemical staining showed the ductal and acinar cells were positive for EMA, variably positive for C-erbB2, focally for CEA, PR, and ER; Myoepithelial cells surrounding the ducts were consecutively reacted to SMA and S-100. Proliferative activity was low with the Ki-67 index less than 1%. Conclusion Sclerosing polycystic adenosis of salivary gland is a rare lesion with specific histopathological characteristics. Recognization of the clinical and pathologic features of this lesion is helpful for diagnosis and differential diagnosis from some other lesions such as chronic sclerosing sialadenitis.

关 键 词：硬化性多囊性腺病 腮腺 鉴别诊断 

分 类 号：R781.72[医药卫生—口腔医学]