不同部位乳头状涎腺瘤样肿瘤8例临床病理分析  

Sialadenoma papilliferum-like tumor:clinicopathologic analyses of 8 cases

作　　者：刘飞飞[1] 秦瑞 宫琳 陈帅 张仁亚[1] LIU Feifei;QIN Rui;GONG Lin;CHEN Shuai;ZHANG Renya(Department of Pathology,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Hepatobiliary Surgery,the 971st Hospital of Chinese People’s Liberation Army Navy,Qingdao 266071,China)

机构地区：[1]山东省济宁医学院附属医院病理科,济宁272029 [2]海军第971医院肝胆外科,青岛266071

出　　处：《临床与实验病理学杂志》2023年第9期1079-1083,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的 探讨乳头状涎腺瘤样肿瘤的临床病理学特征、诊断、鉴别诊断。方法 回顾性分析8例不同部位乳头状涎腺瘤样肿瘤的临床病理资料,采用免疫组化EnVision法和PCR法进行蛋白标记和BRAF基因检测,并复习相关文献。结果 患者平均年龄59.9岁,男女之比为3∶1,发病部位为腭部2例、鼻腔2例、食管2例、肺部2例。镜检:肿瘤边界清楚,具有双相分化特征,包括被覆鳞状上皮的外生乳头状结构和黏膜下的内生腺样结构。管腔衬覆双层或多层上皮,内层细胞呈柱状、立方或扁平,局灶增生呈乳头状突起,细胞质嗜酸性、核小,位于细胞底部;外层基底层细胞呈梭形、扁平状或立方形,细胞质嗜酸性、稀少,两层细胞形态温和,未见病理性核分裂。免疫表型:腔内上皮细胞表达CK(AE1/AE3)、CK7、CK8和BRAF V600E,基底层细胞表达CK14、CK5/6、p63、S-100、SMA,Ki-67增殖指数低(均<10%)。分子检测显示BRAF V600E突变阳性。患者均未见复发,预后良好。结论 乳头状涎腺瘤样肿瘤属于唾液腺型肿瘤,常见于口腔的小唾液腺,也可发生在鼻咽、食管及肺等其他部位,熟悉该特殊类型肿瘤可避免误诊、漏诊。Purpose This study aims to investigate and clarify the clinical and pathological characteristics of sialadenoma papilliferum-like tumor.Methods The clinical,pathological,and molecular genetic characteristics of eight cases of sialadenoma papilliferum-like tumors in varying locations were analyzed retrospectively.The EnVision technique and PCR were used to detect protein markers and the BRAF gene in the eight cases of sialadenoma papilliferum-like tumors.Relevant literatures were reviewed.Results The patients’average age was 59.9 years,with a male-to-female ratio of 3∶1.The onset sites were two cases in the palate,two cases in the nasal cavity,two cases in the esophagus,and two cases in the lungs.Microscopy showed clear tumor margins,biphasic differentiation characteristics,and exogenous papillary structures covered with squamous epithelium and endogenous gland-like structures in the submucosa.The lumen was lined with bilayer or multilayer epithelium with columnar,cuboidal or flat cells in the inner layer,focal proliferation of papillary protrusions,acidophilic cytoplasm,small nuclei located at the bottom of the cells,and the outer basal layer was spindle-shaped,flat,or cuboidal,with acidophilic and sparse cytoplasm.No pathological nuclear mitosis was observed in two layers of cells.The luminal epithelial cells expressed CK(AE1/AE3),CK7,CK8,and BRAF V600E,and the basal layer cells expressed CK14,CK5/6,p63,SMA,and S-100,with a Ki-67 proliferation index of less than 10%in all cases.Molecular testing showed positive BRAF V600E mutation.No recurrence of the disease was observed in the patients,and the prognosis was good.Conclusion Sialadenoma papilliferum-like tumor is a rare type of salivary gland tumor that typically occur in the small salivary glands of the oral cavity,and can also develop in other areas including the nasopharynx,esophagus,and lungs.Familiarizing and mastering this special type of tumor can avoid misdiagnosis and missed diagnosis.

关 键 词：乳头状涎腺瘤样肿瘤 临床特征 组织病理学 免疫组织化学 

分 类 号：R739.8[医药卫生—肿瘤]