阴囊部皮肤原发性腺样囊性癌1例报告及文献复习

目的：探讨原发阴囊部皮肤腺样囊性癌的临床病理特点,免疫组化及鉴别诊断要点。方法：报道1例原发阴囊部皮肤腺样囊性癌的临床、病理组织学形态和免疫组化特点,并复习相关文献对以上特点进行分析。结果：皮肤的腺样囊性癌较少见,可发生于除掌跖以外的任何部位,中老年好发,平均发病年龄为59岁。原发阴囊部皮肤腺样囊性癌未见报道,镜下肿瘤组织形成特殊的筛状结构,囊腔内常含有阿辛兰（pH5.2）阳性的透明质酸和硫酸化的酸性黏蛋白,瘤细胞间和小叶间周围可见透明嗜酸性基底膜物质的沉积,PAS染色呈阳性。免疫组化CK7、S-100、EMA、P63阳性表达。结论：阴囊皮肤原发腺样囊性癌相对少见,其具有与涎腺腺样囊性癌相同的镜下特征和免疫组化特点,临床表现呈惰性过程,预后相对较好。     

外耳道腺样囊性癌临床病理分析及文献复习

目的:探讨外耳道腺样囊性癌的临床病理特点,提高对该病的认识。方法:观察6例外耳道腺样囊性癌的组织学特点及免疫组化特性。结果:患者男性3例,女性3例,年龄41~68岁,平均年龄55岁,6例均有耳部疼痛,2例发生肺转移。肿物最大径0.8~4 cm,实性,无包膜,镜下均以筛状结构为主,伴有不同比例的管状和实性结构,4例见神经浸润,免疫组化CK和p63均阳性。结论:外耳道腺样囊性癌较少见,易发生肺转移,诊断靠病理诊断。     

原发性气管腺样囊性癌15例临床病理分析

目的:探讨15例原发性气管腺样囊性癌患者临床病理学特征,诊断与鉴别诊断以及治疗原则.方法:回顾性分析上海长海医院近2年诊治的15例原发性气管腺样囊性癌患者临床病理资料.结果:原发性气管腺样囊性癌多以呼吸道症状就诊,早期容易误诊.显微镜下:肿瘤组织由腺管状、筛孔状和实性团巢状结构构成,管腔内可见过碘酸雪夫反应(PAS)阳性的黏液样物质.免疫组化显示,肿瘤细胞表达腺上皮和肌上皮标记.结论:原发性气管腺样囊性癌是一种少见的低度恶性肿瘤,临床症状无特异性,行支气管镜检查以及病理活检利于早期诊断,治疗以手术切除及局部放疗较好.     

乳腺腺样囊性癌临床病理观察

目的:探讨乳腺腺样囊性癌临床病理学特点、免疫表型及鉴别诊断要点。方法:分析3例乳腺腺样囊性癌的临床特点、病理组织学形态、免疫组化特点,并复习相关文献。结果:3例乳腺腺样囊性癌均为女性,年龄58~80岁。大体上均为境界相对较清楚的肿块。镜下肿瘤形成管状-梁索状、筛状、实体型结构。肿瘤主要由腺上皮、肌上皮、基底样细胞构成,其中腺上皮表达CK7、CK5/6、CD117,肌上皮表达SMA、p63,基底样细胞表达p63、CK5/6、CD117,但均不表达ER、PR、Her-2。3例乳腺腺样囊性癌均行乳腺癌改良根治术,术后随访至今均无复发。结论:乳腺腺样囊性癌是一种少见的乳腺浸润性癌亚型,有其独特的组织形态学特点,预后较好。     

皮肤腺样囊性癌1例报道

腺样囊性癌是生长缓慢但恶性度高的上皮性肿瘤,好发于腮腺、颌下腺、舌下腺、腭腺等小涎腺及皮肤等组织,其具有局部侵袭性强、远处转移率高、长期预后较差等典型生物学特征.目前,治疗腺样囊性癌主要是采用以手术为主,辅以术后化学治疗、放射治疗和基因分子治疗等综合治疗手段,能显著提高患者疗效及改善患者预后.我们近期诊断皮肤腺样囊性癌1例,现报道如下.     

肾脏转移性腺样囊性癌1例临床病理分析

目的:阐明肾脏转移性腺样囊性癌临床病理特点.方法:回顾性分析1例肾脏转移性腺样囊性癌的临床表现、组织学和免疫组织化学及超微结构特点.结果:右侧腮腺腺样囊性癌根治术后13年发生肾脏转移,肿瘤位于左侧肾脏上极,切面灰白、细腻、质中,与周围组织分界清楚.组织学显示瘤细胞由腺上皮细胞和肌上皮细胞两种细胞构成,肿瘤组织呈条索状、腺囊状或筛网状排列,囊腔内充以嗜碱性黏液样物质,局部可见瘤栓及神经束侵犯.免疫组化结果显示两种肿瘤细胞vimentin阳性;腺上皮细胞CD117阳性;肌上皮细胞actin、p63、34BE12阳性.电镜显示瘤细胞间具有腺腔,瘤细胞巢周围有完整或不完整的基板.结论:腺样囊性癌是一种生长缓慢的恶性上皮性肿瘤,易复发和远处转移,甚至可以转移至肾脏,对此类肿瘤患者应进行长年随访观察.     

Twist在涎腺腺样囊性癌中的表达及其临床意义

目的 探讨转录因子Twist在涎腺腺样囊性癌中的表达水平及其与各临床病理因素的关系.方法 采用免疫组化方法检测48例涎腺腺样囊性癌、18例多形性腺瘤和10正常腮腺组织中Twist蛋白的表达情况,分析Twist表达与腺样囊性癌临床病理因素的关系.结果 Twist在涎腺腺样囊性癌组织中的表达水平明显高于多形性腺瘤和正常腮腺组织(P<0.05).Twist表达与腺样囊性癌的病理分型、嗜神经侵袭、术后复发及远位转移有相关性(P<0.05).结论 Twist蛋白表达可能与涎腺腺样囊性癌的分化调节、嗜神经侵袭及远位转移有关.检测Twist的表达水平对判断腺样囊性癌患者的预后有一定的参考价值.     

肺腺样囊性癌4例病例报告

背景与目的 肺腺样囊性癌是肺癌中的少见类型,通常对其诊断及治疗认识不足.为了提高对肺腺样囊性癌的认识,本文对该病例进行了收集和分析.方法 回顾分析我院2012年1月-2016年12月收治的4例肺腺样囊性癌,对其病理免疫组化、表皮生长因子受体(epidermal growth factor receptor,EGFR)及间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)突变分析、诊断和治疗特点进行总结.结果 肺腺样囊性癌是一种主要发生在气道、EGFR及ALK突变少见、转移较晚、手术治疗效果好的一种疾病.结论 肺腺样囊性癌诊断主要依赖于病理学,早期以手术治疗为主,晚期可行放化疗,但靶向治疗机会不多,其预后较小细胞肺癌及非小细胞肺癌好.     

皮肤腺样囊性癌1例报道

腺样囊性癌是生长缓慢但恶性度高的上皮性肿瘤,好发于腮腺、颌下腺、舌下腺、腭腺等小涎腺及皮肤等组织,其具有局部侵袭性强、远处转移率高、长期预后较差等典型生物学特征。目前,治疗腺样囊性癌主要是采用以手术为主,辅以术后化学治疗、放射治疗和基因分子治疗等综合治疗手段,能显著提高患者疗效及改善患者预后。我们近期诊断皮肤腺样囊性癌1例,现报道如下。     

肾脏转移性腺样囊性癌1例临床病理分析

目的：阐明肾脏转移性腺样囊性癌临床病理特点。方法：回顾性分析1例肾脏转移性腺样囊性癌的临床表现、组织学和免疫组织化学及超微结构特点。结果：右侧腮腺腺样囊性癌根治术后13年发生肾脏转移,肿瘤位于左侧肾脏上极,切面灰白、细腻、质中,与周围组织分界清楚。组织学显示瘤细胞由腺上皮细胞和肌上皮细胞两种细胞构成,肿瘤组织呈条索状、腺囊状或筛网状排列,囊腔内充以嗜碱性黏液样物质,局部可见瘤栓及神经束侵犯。免疫组化结果显示两种肿瘤细胞vimentin阳性;腺上皮细胞CDI17阳性;肌上皮细胞actin、p63、34βE12阳性。电镜显示瘤细胞间具有腺腔,瘤细胞巢周围有完整或不完整的基板。结论：腺样囊性癌是一种生长缓慢的恶性上皮性肿瘤,易复发和远处转移,甚至可以转移至肾脏,对此类肿瘤患者应进行长年随访观察。     

Primary Adenoid Cystic Carcinoma of the Skin with Multiple Local Recurrences

Primary adenoid cystic carcinoma (PACC) of the skin is a rare tumor with fewer than 70 cases studied in detail in the English literature. This type of tumor shows a prolonged course and a growth pattern usually manifested by multiple local recurrences and has a low potential for distant metastases. The most important modality for primary treatment is surgical resection followed by radiotherapy. We report a woman aged 43 years at the time of diagnosis, who presented with a slow-growing nodule in the right axilla without lymph node enlargement. A wide local excision was performed, and the histology revealed an adenoid cystic carcinoma. During the next 24 years, another four local recurrences were excised (the last one in 2015) and confirmed histologically to be adenoid cystic carcinoma. The patient was given 44 Gy of radiotherapy after the second surgery in 1996. PACC of the skin is a rare tumor with insufficient data concerning the efficacy of the surgical technique and chemotherapy and radiotherapy treatment, even more so in the case of multiple recurrences. After the last recurrence, the patient was offered an active follow-up based on the long tumor-free intervals in the past and because the site of the primary tumor allowed further surgical excisions in future recurrences.Key Words: Adenoid cystic carcinoma, Cylindroma, Skin     

Multiple cutaneous metastases from a parotid adenoid cystic carcinoma

Cutaneous metastasis from salivary gland adenoid cystic carcinoma is extremely rare. We report a case of a 39-year-old man that presented multiple cutaneous metastases from a parotid salivary gland adenoid cystic carcinoma. The clinical, histopathological and immunohistochemical features are described and discussed. This case shows the importance of a detailed and periodical skin examination in patients treated for salivary gland adenoid cystic carcinoma.     

Adenoid cystic carcinoma of the lung: Response to tamoxifen after chemoradiation

Primary adenoid cystic carcinoma of the lung is a rare subtype of lung cancer with a prolonged natural history but is difficult to completely resect surgically due to its proximal location. Hence radiotherapy plays a role for local control of these cancers. The role of systemic therapies in the treatment of adenoid cystic carcinoma of the lung remains unclear. Isolated case reports have previously described the treatment of primary adenoid cystic carcinoma of the lung with tamoxifen, resulting in partial control. We report the first case of primary adenoid cystic carcinoma of the lung treated with primary chemoradiotherapy due to unresectable location of the tumor, and disease stabilization with symptomatic response to tamoxifen following tumor recurrence. There is a need for further studies to investigate the role of anti‐hormonal therapies in the treatment of adenoid cystic carcinoma of the lung.     

Ki-67及PTEN在口腔腺样囊性癌中的表达及临床意义

目的 研究口腔腺样囊性癌(OACC)中Ki-67和PTEN的表达情况,及其表达水平与临床病理特征的关系。方法 收集佳木斯大学附属第一医院病理实验室证实的40例口腔腺样囊性癌。另选口腔腺样囊性癌患者标本癌旁正常腺体15例做对照组。免疫组化SP法检测腺样囊性癌中Ki-67蛋白及PTEN的表达。结果 Ki-67蛋白在口腔腺样囊性癌中的阳性率为70%(28/40),明显高于对照组13%(2/15)(P＜0.05)。PTEN蛋白在口腔腺样囊性癌中的阳性率为63%(25/40),明显高于对照组20%(3/15)(P＜0.05)。Ki-67、PTEN的表达与TNM分期、肿瘤组织学类型、远处转移、淋巴结转移和神经节浸润均显著相关,并且Ki-67和PTEN表达存在相关性。结论 Ki-67和PTEN在口腔腺样囊性癌发生和发展过程中可能起重要作用。Ki-67和PTEN蛋白可能作为口腔腺样囊性癌的诊断标志物。     

Primary cutaneous adenoid cystic carcinoma treated with Mohs micrographic surgery toluidine blue technique.

A patient with primary cutaneous adenoid cystic carcinoma treated with Mohs surgery is presented. This tumor is characterized clinically by frequent local recurrences and infrequent metastases. Histologically it demonstrates cribiform islands of tumor cells with an abundance of mucin. Because toluidine blue stains this mucin metachromatically, it may be superior to hematoxylin and eosin for identifying the presence of this tumor. We recommend Mohs micrographic surgery with toluidine blue staining technique for the treatment of adenoid cystic carcinoma.     

Adenoid cystic carcinoma of sweat glands: report of two cases.

Two cases of primary cutaneous adenoid cystic carcinoma (ACC) of sweat gland origin are reported. The patients were a 83-year-old man and a 40-year-old woman. Histologically, the neoplasms showed the classic appearance of ACC. CEA, actin and S-100 protein were immunocytochemically demonstrated to be contained in some neoplastic cells. The literature on sweat gland ACC is reviewed and the clinicopathologic profile of this rare tumor considered.     

Sweat gland differentiation in mammary adenoid cystic carcinoma.

A breast tumor is described which presented as an exophytic mass, and which by both light and electron microscopic examination had a biphasic histologic composition. In the superficial area adjacent to the epidermis, it showed tubular differentiation similar to a cutaneous tubular apocrine adenoma and salivary basal cell adenoma, and, in the deeper portion, it had the characteristic features of adenoid cystic carcinoma. Their possible interrelationships are discussed, and mammary adenoid cystic carcinoma is briefly reviewed.