涎腺微分泌性腺癌的临床病理特征  

Clinicopathological features of salivary gland microsecretory adenocarcinoma

作　　者：安风仙 王正岩 赵阳[1] 张学东[1] 魏建国[2] AN Feng-xian;WANG Zheng-yan;ZHAO Yang;ZHANG Xue-dong;WEI Jian-guo(Department of Pathology,Liaocheng People's Hospital,Liaocheng 252000,China;Department of Pathology,Shaoxing People's Hospital,Shaoxing 312000,China)

机构地区：[1]山东省聊城市人民医院病理科,山东聊城252000 [2]浙江省绍兴市人民医院病理科,浙江绍兴312000

出　　处：《诊断病理学杂志》2023年第6期545-548,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨涎腺微分泌性腺癌(MSA)的临床病理特征、诊断、鉴别诊断及预后。方法分析工作中遇到的1例腭部MSA的临床病理、免疫表型及分子病理特征等,复习相关文献。结果男性,48岁,腭部无痛性肿物20天入院。大体检查肿块直径1.2 cm;镜下瘤细胞主要呈小管状、管囊状,管腔内可见嗜碱性分泌物,瘤细胞扁平,胞质嗜酸,纤维黏液样基质为主。免疫表型:CK7、S-100、P63和SOX10均弥漫阳性;SMA局灶阳性;荧光原位杂交检测SS18基因断裂重排阳性。结论MSA是以MEF2C::SS18融合为特征的单相性低级别涎腺性癌,以微囊和小管结构为主,内衬嗜酸性细胞或扁平的闰管样细胞,腔内可见丰富的嗜碱性分泌物和数量不等的黏液样基质。术中冷冻及常规切片易低诊或误诊为良性病变。Objective To explore the clinicopathological features,diagnosis,differential diagnosis and prognosis of microsecretory adenocarcinoma(MSA)of salivary gland.Methods The clinicopathological features,immunophenotype and molecular pathological features of microsecretory adenocarcinoma of the palate were reviewed.Results A male,48-year-old patient was admitted with a painless palatal mass for 20 days.Gross examination of the mass was 1.2 cm in diameter.Microscopically,the tumor cells were mainly arranged as small tubular and cystic patterns,with basophilic secretions visible in the lumen,and the tumor cells were flat,acidophilic cytoplasm,and mainly fibrinous mucoid matrix.Immunophenotypically,CK7,S-100,P63,and SOX10 were all diffuse positive;SMA was focally positive.Fluorescence in situ hybridization was positive for SS18 gene break rearrangement.Conclusion MSA is a newly recognized monophasic entity of low-grade salivary gland carcinoma characterized by the MEF2C::SS18 fusion,and is dominated by microcystic and tubular structures,lined with eosinophilic cells or flat intercalated duct-like cells,with prominent basophilic secretions and variable amounts of myxohyaline stroma.Intraoperative frozen and routine sections are prone to underdiagnosis or misdiagnosed as benign lesions.

关 键 词：涎腺 微分泌性腺癌 临床病理特征 免疫表型 SS18 

分 类 号：R739.87[医药卫生—肿瘤]