坏死性涎腺化生的临床病理分析

目的:探讨坏死性涎腺化生(NS)的临床病理特征及诊断与鉴别诊断。方法:复习3例NS的临床资料,进行光镜观察、免疫组化标记和人乳头瘤病毒(HPV)原位杂交。结果:NS的组织学特点包括:唾液腺的凝固性坏死、导管上皮鳞化、邻近黏膜上皮的假上皮瘤样增生、间质黏液变性以及唾液腺慢性肉芽肿性炎。NS细胞形态温和,保留了完整的小叶结构,病程有自限性。鳞化的导管上皮表达CK-HMW、P63,不表达CK20、Calponin和S-100。3例NS行HPV原位杂交未见阳性表达。结论:正确的诊断NS这一良性的、具有自愈倾向的炎性病变,可以避免不恰当的治疗。

Necrotizing sialometaplasia: A clinicopathological analysis

Objective: To study the clinicopathological features,diagnosis and differential diagnosis of necrotizing sialometaplasia(NS).Methods: Three cases of NS were studied by clinical data analysis,light microscopy,immunohistochemistry and HPV in situ hybridization.Results: The histological features of NS included coagulation necrosis of glandular acini,squamous metaplasia of salivary ductal epithelia,pseudoepitheliomatous hyperplasia of adjacent epithelia and mucous degeneration in the interstitium with an associated granulomatous inflammatory response.NS cells showed mild pleomorphism,total preservation of the lobular architecture and a benign self-limited process.Immunohistochemically,metaplastic salivary epithelia were positive for CK-HMW and P63,negative for CK20,S-100 and Calponin.HPV in situ hybridization was negative in the 3 cases.Conclusion: Clinical and histological recognition of NS is essential for avoiding inappropriate or unnecessary treatment of this benign self-limited inflammatory condition.