Striated duct adenoma presenting with intra-tumoral hematoma and papillary thyroid carcinoma-like histology.
Striated duct adenoma presenting with intra-tumoral hematoma and papillary thyroid carcinoma-like histology.
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横纹管腺瘤表现为瘤内血肿和甲状腺乳头状癌样组织学。
DOI：
10.1111/pin.12534
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发表时间：
2017
影响因子：
2.2
通讯作者：
Inagaki H.
中科院分区：
文献类型：
--
作者：
Ito Y;Fujii K;Murase T;Saida K;Okumura Y;Takino H;Masaki A;Beppu S;Kawakita D;Ijichi K;Inagaki H.
摘要涎腺横纹管腺瘤是一种罕见的良性肿瘤，其特徴为单层导管上皮及肿瘤细胞膜上的条纹。据我们所知，文献中仅报告了6例。在此，我们报告了另一例病例，其临床表现为肿瘤内血肿，术中冷冻切片诊断为甲状腺乳头状癌样组织学。一名无症状的78岁男性，有2年左侧腮腺无痛性肿瘤病史。根据术前放射学检查结果，怀疑存在肿瘤内血肿，这在唾液腺肿瘤中不常见。患者随后接受了左侧腮腺切除术。术中冷冻切片诊断表明为良性肿瘤，但异位甲状腺乳头状癌被作为鉴别诊断，因为嗜酸性肿瘤细胞偶尔具有核沟和核假包涵体。经石蜡切片之组织病理学检查，最后诊断为横纹管腺瘤。这种类型的肿瘤具有血管丰富的间质和乳头状甲状腺癌样细胞核的独特特征。在我们的病例中，前一个特征与肿瘤内血肿相关，后一个特征在冷冻切片肿瘤诊断中存在困难。
Striated duct adenoma of the salivary gland is a rare benign tumor characterized by unilayered duct epithelium and striations of the tumor cell membranes. To the best of our knowledge, only six cases have been reported in the literature. Here we report an additional case, which was complicated by an intra‐tumoral hematoma on clinical presentation and by papillary thyroid carcinoma‐like histology on intra‐operative frozen section diagnosis. An asymptomatic 78‐year‐old male presented with a two‐year‐history of a painless tumor of the left parotid. An intra‐tumoral hematoma, which is unusual for a salivary gland tumor, was suspected from results of pre‐operative radiology. The patient then underwent a left parotidectomy. The intra‐operative frozen section diagnosis indicated a benign tumor, although ectopic papillary thyroid carcinoma was raised as a differential diagnosis since the eosinophilic tumor cells occasionally possessed nuclear grooves and nuclear pseudo‐inclusions. By precise histopathological examination using paraffin sections, the tumor was finally diagnosed as striated duct adenoma. This type of tumor has unique features of hypervascular stroma and papillary thyroid carcinoma‐like nuclei. In our case, the former feature was associated with the intra‐tumoral hematoma and the latter feature, with difficulty in frozen section tumor diagnosis.