涎腺癌肉瘤3例临床病理观察  

Clinicopathological findings of salivary carcinosarcoma:report of three cases

作　　者：白玉萍[1] 岳常丽[1] 张勇[1] 邢莉[1] 贾双双 刘红刚[1] BAI Yu-ping;YUE Chong-li;ZHANG Yong;XING Li;JIA Shuang-shuang;LIU Hong-gang(Department of Pathology,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院病理科,头颈部分子病理诊断北京市重点实验室,北京100730

出　　处：《诊断病理学杂志》2018年第8期545-548,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨涎腺癌肉瘤的临床病理特点,加深对该肿瘤的认识。方法回顾性分析3例涎腺癌肉瘤的临床病理资料,并进行随访。结果 3例中男性2例,女性1例。年龄66~68岁,平均年龄67岁,中位年龄67岁。2例以无痛性肿物就诊,1例肿物伴疼痛。3例分别发生于右侧腮腺、左侧颌下腺及右侧咽旁间隙。均无涎腺多形性腺瘤病史。组织学上,3例中1例以肉瘤为主,1例以癌为主,1例肉瘤与癌比例相当。肉瘤成分,2例为平滑肌肉瘤,1例为纤维肉瘤;癌成分,3例均包括导管癌和鳞状细胞癌,其中1例还包括少量未分化癌。3例肿瘤中均未发现多形性腺瘤成分。免疫组化:肉瘤成分vimentin均(+),癌成分CK均(+);导管癌AR均(+)。3例中1例肉瘤成分与未分化癌成分呈CK和vimentin双(+)。随访2例,随访时间3~5个月,未出现复发及转移。失访1例。结论涎腺癌肉瘤发病罕见,确诊需依靠组织病理检查,免疫组化染色有助诊断。文献表明该肿瘤恶性程度高,预后差,需长期随访。Objective To investigate the clinicopathological features of carcinosarcoma of salivary glands in order to increase awareness of this entity.Methods The clinicopathological data of 3 cases of salivary carcinosarcoma were retrospectively analyzed.The prognosis of 2 patients was followed up.Results The 3 cases of salivary adenocarcinoma occurred in the right parotid gland,the left submandibular gland and the right pharyngeal space respectively.Patients were2 males and 1 female（ mean age,67 years;median age,67 years;range,66-68 years）.Two patients presented with a painless mass,and the other one with a painful mass.None of them had history of salivary adenomatous adenomas.Histologically,one case of tumor was composed predominantly of sarcoma,one was composed predominantly of carcinoma,and there were roughly equal sarcomatous and carcinomatous components in the other one.As for the type of sarcomatous components,2 cases were leiomyosarcoma and one was fibrosarcoma.The carcinomatous components consisted of ductal adenocarcinoma and squamous cell carcinoma in 2 of 3 cases.Ductal adenocarcinoma,squamous cell carcinoma and a small amount of undifferentiated carcinoma component were noted in the other case of tumor.No pleomorphic adenoma was detected in 3 of the tumors.Immunohistochemically,the sarcomatous component was positive for vimentin in all the cases,the cancerous component was positive for cytokeratin in all the cases,ductal carcinoma was positive for AR in all the cases.In 1 of the 3 cases,both the sarcomatous component and the undifferentiated carcinoma were positive for both cytokeratin and vimentin.Neither local recurence nor metastasis was detected in 2 patients during 3 - 5 months follow-up.One case was lost.Conclusion Carcinosarcoma of salivary is a rare malignant tumor.Conformation of the diagnosis relies on histopathological examination.Immunohistochemical staining is assistant for the diagnosis.The literature indicates that this tumor is a high-grade malignant tumor with poor prognosis,and therefore

关 键 词：涎腺 癌肉瘤 病理学 

分 类 号：R739.87[医药卫生—肿瘤]