嗜酸细胞型黏液表皮样癌临床病理学观察  

Clinicopathological features of oncocytic mucoepidermoid carcinoma

作　　者：张丽华[1] 李堃[2] 王振征[1] 

机构地区：[1]解放军第456医院病理科,山东济南250000 [2]解放军第456医院口腔科,山东济南250000

出　　处：《局解手术学杂志》2017年第7期496-499,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨嗜酸细胞型黏液表皮样癌(OMEC)的临床病理学特征、免疫学表型、诊断和鉴别诊断。方法对1例OMEC行临床病理学和免疫表型分析,并复习相关文献。结果患者磁共振检查示,肿物位于右颌下腺,界限清楚,大小1 cm×1 cm。患者行全部肿瘤和右颌下腺切除术。大体见结节样肿物1枚,大小1 cm×1 cm×0.8 cm,界限清,切面主要为实性,局部可见小囊腔,灰白灰黄色,质硬,未见明显包膜。镜下肿瘤主要由嗜酸性细胞构成,嗜酸性细胞主要排列成巢状、片状结构和少许的微囊结构;局部可见中间型细胞、黏液细胞和表皮样细胞。免疫表型:嗜酸性细胞弥漫高表达CK(AE1/AE3)、EMA和p63。组织化学染色显示,嗜酸性细胞PTAH染色阳性,黏液细胞PAS染色阳性。结论 OMEC是黏液表皮样癌的罕见变异型,嗜酸性细胞弥漫高表达CK、EMA和p63。OMEC需要和嗜酸细胞瘤、嗜酸细胞癌、伴黏液化生的Warthin瘤、多形性腺瘤、嗜酸细胞性肌上皮瘤和肌上皮癌等鉴别。Objective To investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of oncocytic mucoepidermoid carcinoma（OMEC）. Methods A case of OMEC was studied for clinicopathological and immunohistochemical features, the available literature on this subject was reviewed as well. Results Magnetic resonance imaging revealed a well-defined mass, measured 1 em x 1 cm, within the fight submandibular gland. The patient was underwent the total mass and the fight submandibular gland resections. On macro- seopic examination, the well-defined tumor was gray-yellowish on cut surface with hard consistence and was sized 1 cm x 1 em x 0.8 em. The uncapsulated tumor was mainly solid with focal mieroeysts on cut surface. Microscopically, the tumor consisted of nests, sheets, and occasional microcysts of oncocytic cells. Focally, intermediate cells, mucilage cell and epidermoid cell were also present. Immunohistochemically, the on- eocytic cells were diffusely and intensely positive for CK（ AE1/AE3 ）, EMA and P63. By histochemical staining, the oncocytic cells were posi- tive for PTAH staining,and mucilage cell were positive for PAS staining. Conclusion The OMEC is an exeeedingly rare variant of mucoepi- dermoid carcinoma with a good prognosis and should be differentiated from oncoeytoma, oneocytic carcinoma, Warthin＇ s tumor with mucinous metaplasia, pleomorphic adenoma, oncocytic myoepithelioma and myoepithelial carcinoma, et al.

关 键 词：颌下腺 嗜酸性细胞 黏液表皮样癌 肿瘤 

分 类 号：R739.8[医药卫生—肿瘤]