腺样囊性癌样特征颌骨造釉细胞瘤与原发颌骨腺样囊性癌临床、病理特征分析  

Clinicopathological characteristics of ameloblastoma with adenoid cystic carcinoma-like features and primary adenoid cystic carcinoma of the jaw bones

作　　者：马倩[1] 楚慧[1] 刘婷[1] 高永梅 黄晶 马遇庆[1] MA Qian;CHU Hui;LIU Ting;GAO Yong-mei;HUANG Jing;MA Yu-qing(Department of Pathology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院病理科,乌鲁木齐830054

出　　处：《诊断病理学杂志》2023年第7期648-651,656,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的分析腺样囊性癌样特征颌骨造釉细胞瘤与原发颌骨腺样囊性癌临床、病理特征。方法对新疆医科大学第一附属医院2013-02—2022-04原发颌骨腺样囊性癌4例及具有腺样囊性癌特征颌骨造釉细胞瘤14例进行回顾性分析。结果原发颌骨腺样囊性癌女性多见,中位年龄68岁,以上颌骨发生为主;腺样囊性癌样特征颌骨造釉细胞瘤男性多见,中位年龄46岁,以下颌骨发生为主。原发颌骨腺样囊性癌由腺上皮及肌上皮两类细胞组成,可见腺样及囊腔样结构。腺上皮嗜酸性,免疫组化示腺上皮CD117、CK7阳性,肌上皮SMA、calponin阳性。具有腺样囊性癌特征造釉细胞瘤由网状细胞及极性倒置成釉细胞组成,其中亦可见腺腔样结构,免疫组化示P63、P40弥漫阳性,calponin部分阳性,SMA、S-100阴性。结论具有腺样囊性癌特征造釉细胞瘤与原发颌骨腺样囊性癌样形态有交叉,结合病理形态、免疫组化及分子检测可鉴别二者。Objective To analyze the clinicopathological characteristics of ameloblastoma with adenoid cystic carcinomalike features and primary adenoid cystic carcinoma of the jaw bones.Methods A retrospective analysis was performed on 4 cases of primary adenoid cystic carcinoma and 14 cases of ameloblastoma with adenoid cystic carcinoma-like features from February 2013 to April 2022 in the First Affiliated Hospital of Xinjiang Medical University.Results Primary adenoid cystic carcinoma was more commonly found in elderly female with a median age of 68 years favoring maxilla,while ameloblastoma with adenoid cystic carcinoma-like features more commonly occured in male with a median age of 46 years affecting the mandible.Primary adenoid cystic carcinoma consisted of two types of cells and displayed the adenoid and pseudocapsule structures.The glandular epithelium had eosinophilic cytoplasm,showing CD117 and CK7 positive,while myoepithelial cells presented SMA and calponin positive in primary adenoid cystic carcinoma.Reticular cells and basal-like cells with inverted polarity were observed in ameloblastoma with adenoid cystic carcinoma-like features,in which gland-like structures were also seen.The immunohistochemical profiling for ameloblastoma with adenoid cystic carcinoma-like features exhibited diffusely positive for P63 and P40,partially positive for calponin,and negative for SMA and S-100.Conclusion There are overlapping morphological features between ameloblastoma with adenoid cystic carcinoma-like features and primary adenoid cystic carcinoma of the jaw bones.While we can distinguished them by pathological morphology,immunohistochemistry and molecular detection.

关 键 词：腺样囊性癌 腺样囊性癌样特征 造釉细胞瘤 颌骨肿瘤 

分 类 号：R447[医药卫生—诊断学]