低级别阑尾黏液性肿瘤伴肺胸膜转移碰撞阑尾神经内分泌肿瘤的临床病理分析  

Pulmonary pleura metastasis from low-grade appendiceal mucinous neoplasm colliding with appendiceal neuroendocrine tumor:a clinicopathological features

作　　者：樊蕊蕊 高杰 路名芝 FAN Rui-rui;GAO Jie;LU Ming-zhi(Department of Pathology,Xiang’an Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen 361002,China;Department of Pathology,Xiamen Humanity Hospital,Xiamen 361000,China)

机构地区：[1]厦门大学附属翔安医院病理科,福建厦门361002 [2]厦门弘爱医院病理科,福建厦门361000

出　　处：《诊断病理学杂志》2024年第8期728-731,共4页Chinese Journal of Diagnostic Pathology

基　　金：福建省自然科学基金计划资助项目(2023J01013);厦门市自然科学基金项目(3502Z20227118);厦门市医疗卫生指导性项目(3502720244ZD1156)。

摘　　要：目的分析低级别阑尾黏液性肿瘤(LAMN)伴肺胸膜转移碰撞阑尾神经内分泌肿瘤(ANET)的临床病理特征。方法收集LAMN伴肺胸膜转移碰撞ANET患者的临床资料,通过组织形态、免疫组化及特殊染色分析该肿瘤的临床病理特征。结果大体:阑尾、大网膜、腹膜及胸膜均见肿瘤。镜下:阑尾腔内见大量黏液,内壁见轻度异型的柱状上皮细胞,黏膜下层见黏液积聚;大网膜及胸/腹膜结节镜下形态与上述LAMN一致。阑尾体部NET细胞排列成巢团状,核染色质呈胡椒盐状。免疫组化及特殊染色结果:①LAMN及胸/腹膜、大网膜结节表达CK20、CDX2,不表达PAX8、HNF4α、Syn及TTF-1;AB-PAS染色(+)。②ANET表达CgA、Syn、CD56,不表达CDX2。结论LAMN伴肺胸膜转移碰撞ANET具有典型的组织形态及免疫表型,及时准确的诊断对患者的治疗及预后具有重要意义。Objective To investigate the clinicopathologic feature of pulmonary pleura metastasis from low-grade appendical mucinous neoplasm(LAMN)colliding with appendiceal neuroendocrine tumor(ANET).Methods Clinicopathological data of pulmonary pleura metastasis from LAMN colliding with ANET was collected and analyzed by histomorphology,immunohistochemistry and AB-PAS staining.Results Tumors were found in the appendix,omentum,peritoneum and pulmonary pleura.Microscopically,A large amount of mucus was found in the appendiceal cavity,and the inner wall was covered with mucous cells.Local appendiceal mucosal muscle was missing,and tumor cells clung to sclerosed interstitium.The microscopic morphology of omentum and pulmonary pleura/peritoneal tumor was consistent with LAMN.The ANET cells were arranged in nests.The cytoplasm was eosinophilic,the nuclear chromatin was pepper salt.Immunohistochemistry results showed that CK20 and CDX2 were expressed in LAMN,pulmonary pleura/peritoneal and omental nodules,but PAX8,HNF4αor TTF-1 were not.AB-PAS(+).ANET expressed CgA,Syn and CD56,but did not express CDX2.Conclusion The pulmonary pleura metastasis from LAMN colliding with ANET has the characteristic histomorphology and immunophenotype.Timely and accurate diagnosis is of great significance for the treatment and prognosis of the patients.

关 键 词：低级别阑尾黏液性肿瘤 转移 神经内分泌肿瘤 碰撞瘤 诊断 

分 类 号：R735.36[医药卫生—肿瘤]