阑尾杯状细胞腺癌3例临床病理观察  

Goblet cell adenocarcinoma of appendix:a clinicopathological study of three cases

作　　者：郑原印 刘晓斌 毛瑛玉 林茂华 ZHENG Yuan-yin;LIU Xiao-bin;MAO Ying-yu;LIN Mao-hua(Department of Pathology,Mindong Hospital of Fujian Medical University,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院病理科,福建福安355000

出　　处：《诊断病理学杂志》2021年第3期218-220,228,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的结合WHO(2019)消化系统分类关于阑尾杯状细胞腺癌的新解析,分析3例病理特征和免疫表型,进行新进展讨论。方法对3例阑尾杯状细胞腺癌进行组织学观察及免疫表型分析,并结合新进展展开讨论。结果男性3例,平均年龄为66岁。例1:腹痛、腹胀伴肛门停止排气3天;例2:转移性右下腹疼痛1 h余;例3:右下腹痛1天;3例肿瘤均由高脚杯样的黏液细胞、数量不等的内分泌细胞和潘氏细胞组成;3种细胞构成类似肠隐窝的小管结构。免疫组化:内分泌细胞和潘氏细胞Syn、Cg A和CD56均(+);高脚杯样的黏液细胞CK7、CK20、CEA、AB/PAS(+),术后分别随访,例1已死亡,另外2例无复发和转移。结论阑尾杯状细胞腺癌不再被认为是神经内分泌肿瘤的一个亚型,其生物学特征及预后与腺癌更为相似,WHO(2019)消化系统肿瘤分类将其独立出来,具有更高侵袭性的行为。Objective To analyze the pathological features and immunophenotype of goblet cell adenocarcinoma of the appendix in combination with the new paraphrase of WHO digestive system tumor classification in 2019.Methods Three cases of goblet cell adenocarcinoma of the appendix were studied by histological observation and immunophenotypic analysis.Results There were 3 males with an average age of 66 years.Case 1 presented with abdominal pain,abdominal distension with anal flatus for 3 days;Case 2 presented with metastatic right lower quadrant pain for more than 1 hour;Case3 presented with right lower quadrant abdominal pain for 1 day;All 3 tumors were composed of goblet like mucous cells,endocrine cells and Paneth cells.The three kinds of cells formed a tubular structure similar to intestinal crypt.Immunohistochemistry showed than the endocrine cells and Paneth cells were positive for Syn,Cg A and CD56;the goblet like mucous cells were positive for CK7,CK20,CEA and AB/PAS.Case 1 died and the other two did not have recurrence and metastasis.Conclusions Goblet cell adenocarcinoma of the appendix is no longer considered a subtype of neuroendocrine tumors;its biological characteristics and prognosis are more similar to adenocarcinoma,and the WHO classification of digestive system tumors in 2019 separates it from others.It has a more aggressive behavior.

关 键 词：阑尾肿瘤 杯状细胞腺癌 免疫组化 临床病理 

分 类 号：R735.7[医药卫生—肿瘤]