阑尾杯状细胞类癌临床病理分析(附3例)  

Goblet cell carcinoid of the appendix:Clinicopathologic analysis of three cases

作　　者：刘立伟 范德生[1] LIU Liwei;FAN Desheng(Department of Pathology,Baoshan Branch,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine/Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China)

机构地区：[1]上海中医药大学附属曙光医院宝山分院病理科/上海市宝山区中西医结合医院病理科,上海201900

出　　处：《现代肿瘤医学》2021年第24期4348-4352,共5页Journal of Modern Oncology

摘　　要：目的:探讨阑尾杯状细胞类癌(goblet cell carcinoid,GCC)的临床表现、组织病理学特征、免疫组化及特殊染色的特点,提高临床及病理医师对阑尾GCC的认识。方法:回顾性分析2018年7月至2019年4月我院收治的经临床及病理确诊为阑尾GCC的患者资料,对所有病例进行临床资料收集、组织病理学观察、免疫组化与特殊染色检查及预后随访,并结合相关文献进行分析讨论。结果:3例阑尾GCC患者,男性2例,女性1例,平均年龄57岁。3例患者临床表现均为急性阑尾炎。病理组织学观察3例均可见阑尾GCC的经典特征:肿瘤细胞轻度异型,排列成巢状,簇状、腺泡样结构,浸润阑尾肌层,直达浆膜层。1例表现为肿瘤细胞弥漫破坏肌纤维,伴黏液湖形成,灶区可见黏液腺癌成分存在。免疫表型:肿瘤细胞CKpan、CK19、CK18、CK20、EMA、CEA、Syn、CD56、S-100阳性,CgA、CD68阴性。AB-PAS染色阳性。术后分别随访15个月、7个月和8个月,均生存良好,无复发和转移。结论:阑尾GCC临床易与急性阑尾炎相混淆,确诊需病理学检查。手术推荐右半结肠切除术。Objective:To investigate the clinical manifestations,histopathological features,immunohistochemistry and special stain of appendiceal goblet cell carcinoid(GCC)in order to improve the understanding of the clinicians and pathologists on appendiceal GCC.Methods:The patients who were admitted into our hospital from July 2018 to April 2019 and diagnosed as appendiceal GCC by clinicians and pathologists were analyzed retrospectively.Clinical data collection,histopathological observation,immunohistochemistry,special stain and follow-up were performed in all cases,and all were analyzed and discussed with relevant literature.Results:There were two males and one female with the average age of 57 years old.All the three patients showed acute appendicitis and had the classical feature of GCC:The tumor cells were slightly atypical and arranged in nets,clusters and acinar-like structures and infiltrated the muscular layer to the serosa.Diffuse infiltration,myofiber damage and a mucus lake with focal mucus adenocarcinoma component were seen in case 1.CKpan,CK19,CK18,CK20,EMA,CEA,Syn,CD56 and S-100 were positive for the tumor cells,CgA and CD68 were negative.AB-PAS was positive.The patients were followed up for 15 months,7 months and 8 months respectively after operation,and all survived well without recurrence or metastasis.Conclusion:The appendiceal GCC can be confused with acute appendicitis clinically,and its diagnosis requires pathological examination.Right hemicolectomy is recommended.

关 键 词：杯状细胞类癌 阑尾 免疫组织化学 腺癌 

分 类 号：R735.36[医药卫生—肿瘤]