涎腺多形性腺癌伴高级别转化临床病理学观察  

Clinicopathological observation on pleomorphic adenocarcinoma of salivary gland with high-grade transformation

作　　者：任俊奇 汪俊 袁静萍[1] REN Junqi;WANG Jun;YUAN Jingping(Department of Pathology,Renmin Hospital of Wuhan University,Wuhan 430060;Department of Pathology,Hongkong University-Shenzhen Hospital,Shenzhen 518000,China)

机构地区：[1]武汉大学人民医院病理科,武汉430060 [2]香港大学深圳医院病理科,广东深圳518000

出　　处：《临床与病理杂志》2020年第5期1330-1336,共7页Journal of Clinical and Pathological Research

摘　　要：收集3例不寻常形态学涎腺多形性腺癌(polymorphous adenocarcinoma,PAC),1例伴高级别转化,1例仅表现为实性巢状结构,1例发生于腮腺,进行相关免疫组织化学染色,重点对比观察伴高级别转化的PAC病理形态学改变,探讨PAC组织病理学、免疫组织化学、发生机制及其鉴别诊断。在光镜下伴高级别转化的PAC整体仍保持相对一致性细胞学形态,其细胞体积普遍略偏大,大部分细胞核仍呈淡染空泡状,但核分裂明显活跃;高级别转化区呈实性巢状及筛状,细胞核明显增大,深染,可见瘤巨细胞,免疫组织化学提示同时具有导管上皮和肌上皮分化。PAC以细胞形态学一致性和组织学结构多样性为特征,浸润性生长,表现为高级别转化,提示更为侵袭性的生物学行为。Three unusual morphological polymorphous adenocarcinomas(PACs)were collected from our files,1 case with high-grade transformation,1 case with solid sheets and nested architectures,1 located at parotid gland.Our emphases are high-grade transformation and its histopathological,immunohistochemical,possible mechanism of tumorigenesis,and differential diagnoses.Microscopically keeping with the uniformity of the cytological morphology at a higher atypical nucleus and showed mitotic activity,the high-grade area showed solid nested and cribriform patterns;the nuclei were enlarged and palely stained predominantly,focal giant tumor cells could be seen,and immunohistochemistry suggested that both ductal and myoepithelial differentiation were present.PAC is an infiltrating tumor with cytological uniformity and architectural diversity,high-grade transformation is very rare,which may indicate a more aggressive behavior and should be differentiated from other mimics.

关 键 词：涎腺 多形性低度恶性腺癌 多形性腺癌 高级别转化 

分 类 号：R739.8[医药卫生—肿瘤]