中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2015年
1期
27-31
,共5页
杜艳%赵华%张智弘%范钦和%宋国新%张炜明%王聪
杜豔%趙華%張智弘%範欽和%宋國新%張煒明%王聰
두염%조화%장지홍%범흠화%송국신%장위명%왕총
食管肿瘤%癌,腺样囊性%诊断,鉴别%免疫组织化学
食管腫瘤%癌,腺樣囊性%診斷,鑒彆%免疫組織化學
식관종류%암,선양낭성%진단,감별%면역조직화학
Esophageal neoplasms%Carcinoma,adenoid cystic%Diagnosis,differential%Immunohistochemistry
目的 探讨食管腺样囊性癌的临床病理特点及鉴别诊断.方法 总结10例发生于食管的腺样囊性癌,分析其临床病理学、免疫组织化学特征及鉴别诊断.结果 患者中男性9例,女性1例,发病年龄59～76岁.肿瘤部位:4例位于食管中段,4例位于食管中下段,2例位于食管下段.低倍镜下肿瘤均为推挤性的生长方式,结构以筛状、实性混合为主,局灶呈小管状,瘤细胞核深染,核质比高,部分示导管和肌上皮分化的特征,部分间质显示黏液透明样变.8例伴有实性细胞巢中央的坏死,1例表面鳞状上皮伴中-重度不典型增生,3例伴有小灶鳞状细胞癌成分.免疫组织化学显示瘤细胞p63 (10/10)、S-100蛋白(9/10)、calponin(2/10)、平滑肌肌动蛋白(2/10)、CD117(10/10)、细胞角蛋白7腺管样成分(10/10)阳性.结论 食管腺样囊性癌作为独立的肿瘤实体,有其独特的形态学特征,免疫表型呈S-100蛋白表达以及恒定的表达CD117,需与基底细胞样鳞状细胞癌、黏液表皮样癌、小细胞癌鉴别.
目的 探討食管腺樣囊性癌的臨床病理特點及鑒彆診斷.方法 總結10例髮生于食管的腺樣囊性癌,分析其臨床病理學、免疫組織化學特徵及鑒彆診斷.結果 患者中男性9例,女性1例,髮病年齡59～76歲.腫瘤部位:4例位于食管中段,4例位于食管中下段,2例位于食管下段.低倍鏡下腫瘤均為推擠性的生長方式,結構以篩狀、實性混閤為主,跼竈呈小管狀,瘤細胞覈深染,覈質比高,部分示導管和肌上皮分化的特徵,部分間質顯示黏液透明樣變.8例伴有實性細胞巢中央的壞死,1例錶麵鱗狀上皮伴中-重度不典型增生,3例伴有小竈鱗狀細胞癌成分.免疫組織化學顯示瘤細胞p63 (10/10)、S-100蛋白(9/10)、calponin(2/10)、平滑肌肌動蛋白(2/10)、CD117(10/10)、細胞角蛋白7腺管樣成分(10/10)暘性.結論 食管腺樣囊性癌作為獨立的腫瘤實體,有其獨特的形態學特徵,免疫錶型呈S-100蛋白錶達以及恆定的錶達CD117,需與基底細胞樣鱗狀細胞癌、黏液錶皮樣癌、小細胞癌鑒彆.
목적 탐토식관선양낭성암적림상병리특점급감별진단.방법 총결10례발생우식관적선양낭성암,분석기림상병이학、면역조직화학특정급감별진단.결과 환자중남성9례,녀성1례,발병년령59～76세.종류부위:4례위우식관중단,4례위우식관중하단,2례위우식관하단.저배경하종류균위추제성적생장방식,결구이사상、실성혼합위주,국조정소관상,류세포핵심염,핵질비고,부분시도관화기상피분화적특정,부분간질현시점액투명양변.8례반유실성세포소중앙적배사,1례표면린상상피반중-중도불전형증생,3례반유소조린상세포암성분.면역조직화학현시류세포p63 (10/10)、S-100단백(9/10)、calponin(2/10)、평활기기동단백(2/10)、CD117(10/10)、세포각단백7선관양성분(10/10)양성.결론 식관선양낭성암작위독립적종류실체,유기독특적형태학특정,면역표형정S-100단백표체이급항정적표체CD117,수여기저세포양린상세포암、점액표피양암、소세포암감별.
Objective To study the clinicopathologic features and differential diagnosis of adenoid cystic carcinoma in the esophagus.Methods Ten cases of primary adenoid cystic carcinoma of the esophagus were retrieved from the archival file.The clinicopathologic and immunohistochemical features were studied.The differential diagnosis was analyzed.Results The male-to-female ratio was 9:1.The age of patients ranged from 59 to 76 years.There were 4 cases with tumor located in mid esophagus,4 cases with tumor located in mid to lower esophagus and the remaining 2 cases in lower esophagus.Low-power histologic examination showed mainly expansive growth pattern,with cribriform,solid and focal tubular architectures identified.The tumor cells showed nuclear hyperchromasia.Both ductal and myoepithelial differentiation was demonstrated.The stroma showed myxoid degeneration in areas.Comedo-type necrosis was observed in 8 cases and moderate to severe squamous dysplasia was present in one case.Three cases showed focal areas of squamous cell carcinoma.Immunohistochemical study showed that the tumor cells were positive for p63 (10/10),CD117 (10/10) and S-100 protein (9/10).There was focal staining for calponin (2/10) and smooth muscle actin (2/10).The ductal structures expressed CK7 (10/10).Conclusions Adenoid cystic carcinoma of the esophagus demonstrates unique morphologic features with expression of S-100 protein and consistent expression of CD117.The above characteristics help to distinguish this entity from basaloid squamous cell carcinoma,mucoepidermoid carcinoma and small cell carcinoma of the esophagus.
