腮腺Warthin瘤上皮成分恶变为黏液表皮样癌5例临床病理分析

发布时间：2018-10-05 07:08

【摘要】：目的探讨Warthin瘤上皮成分恶变为黏液表皮样癌的临床及病理学特点。方法收集并分析5例Warthin瘤上皮成分恶变为黏液表皮样癌的病例,研究其临床特点、病理形态学特点、免疫表型以及组织化学染色特点,并复习相关文献。结果 5例患者中,男性3例,女性2例,年龄26~63岁,平均年龄45.6岁。临床均表现为腮腺区无痛性肿物。肿物呈结节状,其中2例有完整包膜,3例包膜不完整,包膜不完整区域与周围组织界限欠清;切面大多为实性、灰褐色。镜下黏液表皮样癌组织位于Warthin瘤瘤体内或肿瘤一侧,两者之间可见移行区。其中4例为低级别黏液表皮样癌,1例为高级别黏液表皮样癌。Warthin瘤嗜酸性上皮CK34βE12、CK5/6和CK7(+),p63、CK20和CEA(-);黏液表皮样癌黏液细胞CK7和CEA(+),CK5/6、p63、CK34βE12和CK20均为(-);Warthin瘤的基底细胞及黏液表皮样癌的表皮样细胞CK5/6、p63和CK34βE12均(+),而CK7、CK20和CEA(-);Ki-67阳性指数在黏液表皮样癌区域高于Warthin瘤区域。黏液细胞PAS染色(+)。结论 Warthin瘤上皮成分恶变为黏液表皮样癌极为罕见,有病理诊断主要依据组织学形态:明确的黏液表皮样癌形态及二者上皮成分移行。
[Abstract]:Objective to investigate the clinical and pathological features of malignant transformation of epithelial components of Warthin tumor into mucoepidermoid carcinoma. Methods five cases of malignant transformation of epithelial component of Warthin tumor into mucoepidermoid carcinoma were collected and analyzed. The clinical features, pathomorphological features, immunophenotype and histochemical staining were studied. Results among the 5 patients, 3 were male and 2 were female. The average age was 45.6 years. The clinical manifestations were painless masses in the parotid region. The tumor was nodular in shape, 3 cases had incomplete capsule, the boundary between the incomplete area and surrounding tissue was not clear, and the cut plane was solid and grayish brown. The mucoepidermoid carcinoma was located in the tumor of Warthin or on one side of the tumor under microscope. Among them, 4 cases were low grade mucoepidermoid carcinoma. One case was high grade mucoepidermoid carcinoma. One case was eosinophilic epithelium CK34 尾 E12CK5 / 6 and CK7 () p63 CK20 and CEA (-); the mucoepidermoid carcinoma mucous cell line CK7 and CEA () CK5 / 6 p63CK34 尾 E12 and CK20 were basal cells and mucoepidermoid cells of (-) Warthin tumor. Both CK5/6,p63 and CK34 尾 E12 of epidermoid cells were (), and the positive index of CK7,CK20 and CEA (-) Ki-67 in mucoepidermoid carcinoma was higher than that in Warthin tumor. PAS staining of (). In mucous cells Conclusion malignant transformation of epithelial components into mucoepidermoid carcinoma is very rare in Warthin tumor. Pathological diagnosis is mainly based on histological morphology: clear morphology of mucoepidermoid carcinoma and migration of both epithelial components.
【作者单位】：解放军总医院病理科;
【分类号】：R739.87

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