High-grade epithelial-myoepithelial carcinoma of the parotid gland with mucous cell differentiation.
High-grade epithelial-myoepithelial carcinoma of the parotid gland with mucous cell differentiation.
复制标题
腮腺高级别上皮肌上皮癌，伴有粘液细胞分化。
DOI：
10.1111/pin.12315
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Yasui W.
中科院分区：
文献类型：
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作者：
Sentani K;Ogawa I;Uraoka N;Ikeda M;Hayashi N;Hattori T;Hattori Y;Oue N;Takata T;Yasui W.
上皮-肌上皮癌（EMC）是一种罕见的涎腺肿瘤，恶性程度较低，具有高度组织病理学特征的EMC非常罕见。此外，具有细胞内粘蛋白的EMC也非常罕见。我们报告了一例66岁日本女性腮腺高级别EMC伴粘液细胞分化的罕见病例，她在一年内发现右侧可触及腮腺肿块大小增加。细胞学标本显示局灶性双相结构，包括孤立或松散的堆积簇，其中透明球被具有核分裂的肿瘤细胞包围。大体检查显示边界相对良好的多结节灰白色实性肿块。组织学上，肿瘤由大小不等的实性巢或小梁组成，中央坏死，核分裂活性增加，并侵入邻近的骨骼肌。免疫组化显示，该肿瘤的双相导管和肌上皮分化证实了高级别EMC的诊断。此外，许多小巢与d-PAS和阿新蓝阳性粘液细胞占整个肿瘤的约5%，这些粘液细胞被肿瘤性肌上皮细胞包围。我们应该认识到EMC的这种变体，因为即使存在粘液细胞，我们也不能排除EMC的可能性。
Epithelial‐myoepithelial carcinoma (EMC) is a rare salivary gland tumor with a low‐grade malignancy, and EMC with high‐grade histopathological features is exceedingly rare. Furthermore, EMC with intracellular mucin is also extremely rare. We report an uncommon case of a high‐grade EMC of the parotid gland with mucous cell differentiation in a 66‐year old Japanese woman who noticed a right palpable parotid mass increasing in size within a one‐year period. The cytological specimen showed a focally biphasic structure and included isolated or discohesive piled‐up clusters with hyaline globules surrounded by neoplastic cells with nuclear atypia. The gross examination revealed a relatively well‐demarcated, multinodular gray‐whitish and solid mass. Histologically, the tumor consisted of variably sized solid nests or trabeculae with central necrosis and increased mitotic activity, and invaded into adjacent skeletal muscles. Immunohistochemically, the biphasic ductal and myoepithelial differentiation of this tumor confirmed the diagnosis of high‐grade EMC. Furthermore, numerous small nests with d‐PAS and alcian blue‐positive mucous cells predominated in about 5% of the whole tumor, and these mucous cells were encompassed by neoplastic myoepithelial cells. We should recognize this variant of EMC because we can't rule out the possibility of EMC even in the presence of mucous cells.