阑尾杯状细胞腺癌2例临床病理分析  

Clinicopathological Analysis of 2 Cases of Goblet Cell Adenocarcinoma of the Appendix

作　　者：徐延钧[1] 连长红[1] 杨苏敏 申向东[2] 马良[3] Xu Yanjun;Lian Changhong;Yang Sumin(Department of Gastrointestinal Surgery,Peace Hospital Affiliated to Changzhi Medical College)

机构地区：[1]长治医学院附属和平医院胃肠外科,046000 [2]长治医学院附属和平医院病理科 [3]长治医学院附属和平医院检验科

出　　处：《长治医学院学报》2020年第4期283-287,共5页Journal of Changzhi Medical College

基　　金：山西省1331工程项目重点创新团队;长治医学院科技创新团队(CX201405)。

摘　　要：目的:探讨阑尾杯状细胞腺癌的临床病理特征、免疫表型、分类及其诊断和鉴别诊断。方法:对2例阑尾杯状细胞腺癌患者的阑尾进行组织学及免疫组织化学观察,并复习相关文献。结果:患者临床上多表现为阑尾炎的症状和体征。大体无明显肿块形成,表现为阑尾弥漫性增厚。镜下见阑尾黏膜无前驱病变存在,瘤细胞绕阑尾壁同心圆状浸润并侵及浆膜。经典杯状细胞腺癌由类似肠腺杯状细胞,少量神经内分泌细胞,偶见潘氏细胞共同组成均一小簇状无腔腺泡样结构,高级别转化后出现不同形态的腺癌成分。免疫组化显示表达腺上皮及神经内分泌标记。结论:杯状细胞腺癌有独特的病理特征和生物学行为,临床医师和病理医生应提高对该病的认识,以免漏诊和误诊。Objective: To investigate the clinicopathological feature, immunophenotype, classfication, diagnosis and differential diagnosis of appendical gobelet cell adenocarcinoma. Methods: 2 cases appendical gobelet cell adenocarcinoma were analyzed for their histomophology and immunophenotype, and related literatures were reviewed. Results: The clinical manifestations of patients were mostly appendicitis symptoms and signs. There was no obvious mass formation, which showed diffuse thickening of the appendix. Under the microscope, there was no precursor lesion in the appendix mucosa, and the tumor cells infiltrated concentrically around the appendix wall and invaded the serosa. Classic goblet cell adenocarcinoma was composed of intestinal gland goblet cells, a small amount of neuroendocrine cells, and occasionally Paneth cells to form a uniform small cluster of non-cavity acinar-like structures. After high-level transformation, different forms of adenocarcinoma components appear. Immunohistochemistry showed expression of glandular epithelium and neuroendocrine markers. Conclusion: Goblet cell adenocarcinoma has unique pathological characteristics and biological behaviors. Clinicians and pathologists should improve their understanding of the disease to avoid missed diagnosis and misdiagnosis.

关 键 词：阑尾杯状细胞腺癌 免疫组化 临床病理特征 鉴别诊断 

分 类 号：R730.4[医药卫生—肿瘤]