Pineal gland differentiation in mature teratoma: An under‐recognized condition and potential pitfalls for overdiagnosis
Pineal gland differentiation in mature teratoma: An under‐recognized condition and potential pitfalls for overdiagnosis
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成熟畸胎瘤中的松果体分化：一种未被充分认识的疾病和过度诊断的潜在陷阱
DOI：
10.1111/pin.13156
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发表时间：
2021
影响因子：
2.2
通讯作者：
Itoh Tomoo
中科院分区：
文献类型：
--
作者：
Kanzawa Maki;Kodama Takayuki;Maruguchi Hayato;Gon Hidetoshi;Tsukamoto Ryuko;Komatsu Masato;Nomura Tadashi;Hirose Takanori;Itoh Tomoo
我们在此报告三例成熟畸胎瘤伴松果体分化，这是一种鲜为人知的现象。病例1为6岁男性，颈部有肿块；病例2为23岁女性，腹膜后有肿块；病例3为45岁女性，腹膜后有肿块。每个病例都表现出典型的成熟畸胎瘤的宏观和组织学表现，如实性和囊性病变，主要衬有成熟的鳞状上皮。所有病例均出现神经胶质分化。成熟神经胶质组织的中心或附近可见小的分叶细胞巢灶。细胞有清晰到苍白的嗜酸性细胞质，细胞核小而圆。免疫组织化学结果显示，细胞中突触素、神经丝蛋白和锥杆同源盒蛋白呈阳性反应，这些蛋白在血管周围呈“棍棒状肿胀”模式。据我们所知，这是第一个关于成熟畸胎瘤中出现松果体分化的报告，成熟畸胎瘤很容易被忽视或误诊为躯体型肿瘤，特别是神经内分泌肿瘤。为了避免过度治疗，病理学家需要意识到成熟畸胎瘤可能发生松果体分化。
We herein report three cases of mature teratomas with pineal gland differentiation, which is a less recognized phenomenon. Case 1 was a 6‐year‐old male with a neck mass, Case 2 was a 23‐year‐old female with a retroperitoneal mass, and Case 3 was a 45‐year‐old female with a retroperitoneal mass. Each case showed the typical macroscopic and histological findings of mature teratoma, such as solid and cystic lesions mainly lined with a mature squamous epithelium. All cases also showed glial differentiation. Small foci of lobulated cell nests were detected in the center of or adjacent to mature glial tissue. Cells had a clear to pale eosinophilic cytoplasm with small round nuclei. Immunohistochemically, cells were positive for synaptophysin, neurofilament protein with a perivascular “club‐shaped swelling” pattern, and cone‐rod homeobox protein. To the best of our knowledge, this is the first report of pineal gland differentiation arising in mature teratoma, which may be easily overlooked or misdiagnosed as somatic‐type tumors, particularly neuroendocrine tumors. To avoid overtreatment, pathologists need to be aware that pineal gland differentiation may occur in mature teratomas.