涎腺肌上皮瘤31例临床病理学分析

目的 分析涎腺肌上皮瘤(myoepithelioma,ME)临床病理学特点及生物学行为。方法 对1992年1月至2000年8月收治的31例患者进行回顾性分析。结果 ME主要发生于腮腺及腭部。临床上表现为无痛性缓慢生长的包块,无面瘫及破溃。光镜下呈实性、黏液性、网状或混合性生长方式。肿瘤细胞有梭形、浆细胞样、透明细胞样、上皮样型或混合型。4例肿瘤细胞生长活跃,在侵袭性生长的病例中可见轻度的细胞异型性、有丝分裂增加及包膜浸润。所有病例均采用手术切除。28例患者术后无复发。3例肿物复发或恶变为肌上皮癌。结论 ME是一类少见的肿瘤,具有独立的临床病理学特点,部分肿瘤侵袭性生长并具有潜在恶性的特点。

A Clinicopathologic Analysis of Myoepithelioma of the Salivary Glands

Objective To analyze the clinicopathologic features and biological behaviors of the myoepithelioma(ME) .Methods We reviewed 31 patients with ME from Jan. 1992 to Aug. 2000 after 1-month to 10-year follow-up. Results Among the 31 patients, 17 were female. The ME occurred preferentially in the parotid gland and minor salivary gland of the palate.Compared with pleomorphic adenomas,the proportion of ME in the palate increased greatly. The clinical history was usually that of a slowly enlarging painless mass with neither facial nerve palsy nor ulceration. The microscopic appearances encompassed solid, myxoid and reticular growth patterns, or combinations of these. The cells showed spindle-shaped,plasmacytoid,clear and epithelioid, or combinations of these, cells of 4 cases proliferated actively. Slightly cytological polymorphism, increased mitotic activity and capsular invasions could be seen in the invasive growth pattern. Treatment was a complete surgical excision. 28 cases showed no recurrences. 3 cases relapsed or transformed to myoepithelial carcinoma. Conclusion ME was a rare neoplasm which had its own clinicopathologic features and a variety of growth patterns. Part of the ME suggested aggressive or malignant potential.