肺黏液表皮样癌12例临床病理分析

目的 探讨肺黏液表皮样癌(pulmonary mucoepidermoid carcinoma,PMC)临床与病理学特征、诊断与鉴别诊断、治疗及预后.方法 对12例PMC进行组织形态学和免疫组织化学检查,结合文献复习进行分析并随访.结果 12例PMC中7例行支气管镜活检显示黏膜下肿物,呈息肉样突向管腔,部分表面可见破溃,界限较清.病理形态显示12例PMC均由黏液细胞、鳞状细胞和中间型细胞构成,细胞分化程度较高,PAS、AB-PAS染色阳性.免疫组化染色示肿瘤细胞CAM5.2、HCK和p63均(+),Ki-67增殖指数为10%左右.12例均行手术治疗,均未见淋巴结转移,随访其中10例均无复发或死亡.结论 PMC较少见,为低度恶性肿瘤.临床症状无特异性,容易误诊.支气管镜活检有助于早期诊断,手术切除预后较好.     

肺黏液表皮样癌的分子特征

目的:探讨肺黏液表皮样癌的分子特征.方法:回顾性对2013年7月至2016年12月13例病理确诊并接受治疗的肺黏液表皮样癌临床特征和分子特点进行分析.结果:EGFR基因突变率为15.38%(2/13),且2例均为L861Q点突变,EGFR基因状态与性别(P=1.000)、年龄(P=1.000)、吸烟史(P=0.848)及分期(P=1.000)均无相关性;MAML2融合基因阳性率为45.45%(5/11),MAML2融合基因状态与性别(P=0.521)、年龄(P=0.521)、吸烟史(P=1.000)及分期(P=0.924)均无相关性(P>0.05).结论:肺黏液表皮样癌中EGFR基因最常见的突变为L861Q,EGFR基因野生型患者中存在MALM2基因融合.     

唾液腺Warthin瘤样黏液表皮样癌3例临床病理分析

目的 探讨唾液腺Warthin瘤样黏液表皮样癌(Warthin-like mucoepidermoid carcinoma,WT-MEC)的临床病理特点、诊断与鉴别诊断.方法 收集3例WT-MEC的临床资料,行HE、免疫组化、PAS/D-PAS染色,应用FISH断裂探针检测MAML2(11q21)基因重排,并复习相关文...     

颈部淋巴结黏液表皮样癌

目的 探讨颈部淋巴结黏液表皮样癌的临床病理特点及鉴别诊断.方法 对1例颈部淋巴结黏液表皮样癌的临床病理特点进行分析并复习文献.结果 患者3次入院手术病理检查组织形态有较大变化.第一次活检标本镜下见淋巴结包膜完整,结内肿瘤组织主要由3种细胞构成:黏液细胞、中间型细胞及表皮样细胞,并可见较多含黏液的囊腔结构.第二次见肿瘤仍位于淋巴结内,主要由表皮样细胞构成,偶见分泌黏液的细胞,含黏液的囊腔结构几乎全部消失.第三次活检标本见横纹肌内浸润的癌细胞巢主要由表皮样细胞构成.随访2年,未见其他部位肿瘤.结论 (1)颈部淋巴结可能会发生原发性的涎腺黏液表皮样癌.(2)颈部淋巴结的黏液表皮样癌可反复复发并发生结外浸润.(3)随着病变进展和(或)复发,黏液表皮样癌的分化程度会逐渐降低,组织病理学形态会发生相应改变.     

胸腺黏液表皮样癌1例

正患者男性,26岁,2019年5月1日因“外院CT检查发现胸部前纵隔结节”入我院就诊。患者一般情况可,无胸痛、胸闷、憋喘,无发热、寒战,无恶心、呕吐,无四肢无力、眼睑下垂等不适。强化CT示:前上纵膈多发结节,淋巴结可能。既往强直性脊柱炎病史,规律服药治疗,有青霉素、链霉素过敏史,体格检查及实验室检测无明显异常。于5月4日在全麻气管插管胸腔镜经剑突下行前纵隔肿瘤切除术,     

原发性涎腺黏液表皮样癌临床病理特征及MAML2基因重排的意义

目的 探讨原发性涎腺黏液表皮样癌(mucoepidermoid carcinoma,MEC)中MAML2基因重排与临床病理特征的相关性.方法 采用荧光原位杂交(fluorescence in situ hybridization,FISH)检测28例原发性涎腺MEC中MAML2基因重排;应用免疫组化EnVision两步...     

腮腺硬化型黏液表皮样癌1例临床病理学观察并文献复习

目的 探讨腮腺硬化型黏液表皮样癌(sclerosing mucoepidermoid carcinoma,SMEC)的临床特点、组织学特征及鉴别诊断.方法 采用免疫组化EnVision两步法对SMEC标本进行染色,结合临床资料并复习相关文献,分析其形态学特征及免疫表型.结果 肿瘤与周围腮腺组织混杂存在,中央硬化,外周淋巴细胞及少量嗜酸细胞浸润,并见鳞状细胞巢及黏液细胞.免疫表型:黏液细胞CEA、CKL均(+),非角化的表皮样细胞及中间型细胞CEA(-),表皮样细胞CKH(+),Ki-67、c-erbB-2均(-).结论 腮腺SMEC发病率极低,属于低度恶性肿瘤.     

MAML2重排阴性腮腺Warthin瘤样黏液表皮样癌1例并文献复习

目的 探讨原发于腮腺MAML2重排阴性的Warthin瘤样黏液表皮样癌(Warthin-like mucoepidermoid carcinoma, WT-MEC)的临床病理特征、诊断和鉴别诊断。方法 收集1例原发于腮腺的WT-MEC临床资料,采用免疫组化EnVision两步法染色和FISH检测,分析其临床病理特征和预后的关系,并复习相关文献。结果 眼观：肿瘤呈实性,多小叶状,边界大部分清楚,切面灰白、灰黄色,局部呈蜂窝状伴点灶性出血。镜检：大量呈多层排列的嗜酸性上皮、部分透明细胞样上皮,丰富的非肿瘤性淋巴细胞间质,可见淋巴滤泡。嗜酸性上皮细胞呈圆形或卵圆形、泡状核和嗜酸性胞质,核仁清楚,上皮内可见异型黏液细胞,还可见灶性分布的中间细胞和表皮样细胞。免疫表型：上皮细胞CK35βH11阳性、CD117部分阳性,表皮样细胞和中间细胞CK5/6、p63局灶阳性,S-100阴性,AB染色黏液呈阳性,Ki67增殖指数<5%。FISH检测：MAML2重排阴性。结论 MAML2基因易位是诊断WT-MEC的金标准,当MAML2重排阴性不能除外时,需根据组织病理学特征和免疫组化综合分析。     

腮腺Warthin瘤上皮成分癌变为黏液表皮样癌的临床病理观察

目的 探讨Warthin瘤上皮成分癌变为黏液表皮样癌的临床病理学特征.方法 分析1例Warthin瘤上皮成分癌变为黏液表皮样癌的组织学及免疫表型特征,并复习相关文献.结果 镜下可见Warthin瘤上皮成分被黏液及鳞状化生并伴不典型增生的上皮组织取代,直接移行为黏液表皮样癌.结论 Warthin瘤上皮成分癌变并直接移行为黏液表皮样癌极为罕见,其病理诊断要点关键在于是否存在明确的黏液表皮样癌及二者移行区.     

Prognostic factors of primary pulmonary mucoepidermoid carcinoma: a clinical and pathological analysis of 34 cases

Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignant neoplasm, and little is known about the prognostic factors. The aim of the present study was to identify the relationship between tumor’s histological features and clinical behaviors and to analyze the survival of patients with PMEC. A total of 34 patients with PMEC from May 2001 to April 2013 were included in the investigation. The clinical data, radiological manifestation, pathological findings, treatment strategy, and prognoses of all patients were analyzed retrospectively. The patients were classified into low-grade group (n = 25) and high-grade group (n = 9), based on histological grades. High-grade PMEC was more common in patient with elevated serum carcinoembryonic antigen (CEA) (P = 0.033), advanced tumor-node-metastasis (TNM) stage (P = 0.004) and lymph node metastasis (P < 0.001). The 5-year PFS and OS of all patients were 75.7% and 83.6%, respectively. Age, pathological grade, lymph node metastasis and TNM stage were correlated with the survival of PMEC patients. Lymph node metastasis was an independent predictor of OS (HR, 0.080; P = 0.029) and PFS (HR, 0.090; P = 0. 004). A higher tumor histological grade indicated a more aggressive behavior. Patients who had undergone complete resection for PMEC without any lymph node metastasis were expected to be cured.     

Central mucoepidermoid carcinoma arising from glandular odontogenic cyst confirmed by analysis of MAML2 rearrangement: A case report

Central mucoepidermoid carcinoma (MEC) poses a diagnostic challenge because of its rarity and histological overlap with glandular odontogenic cyst (GOC). In MEC of both salivary glands and jaws, MAML2 arrangement has been well known as the specific gene alteration. We report a case of central MEC arising from GOC diagnosed by MAML2 fusion gene. A 57‐year‐old male presented a multilocular cystic lesion in left molar region of the mandible. Histopathologically, multiple cysts lined by thin cuboidal or non‐keratinized squamous epithelium with small duct‐like structures, mucous cells and ciliated cells were present. It was diagnosed as GOC. The recurrent lesion after nine years showed the proliferation of many cystic and solid nests composed of epidermoid, mucous and intermediated cells. Nested PCR revealed CRTC3‐MAML2 fusion gene in the recurrent lesion, but not in the primary one. Similarly, MAML‐2 rearrangement by FISH analysis was positive in the recurrent lesion, while negative for the primary one, thus confirming the diagnosis of central MEC arising from GOC. Analysis of MAML2 rearrangement can be used as a supportive evidence to distinguish central MEC from GOC.     

Breast mucoepidermoid carcinoma: a case report and review of literature

Breast mucoepidermoid carcinoma (MEC) is clinically rare, with an estimated incidence of 0.2-0.3% of all primary breast tumors. To date, only 41 cases have been reported in the literature. Herein, we present a case of breast MEC diagnosed at our hospital. The clinicopathologic features were preliminarily discussed by reviewing the literature. A 42-year-old Chinese woman presented with a lump in her right breast that was detected approximately three months prior. A microscopic examination showed that the breast MEC was composed of different proportions of mucinous cells, intermediate cells, and epidermoid cells. Most mucinous cells were positive for cytokeratin 7, while the epidermoid and intermediate cells were positive for p63 and cytokeratin 5/6. All tumor cells were negative for other myoepithelial markers, such as calponin. Tumor cells did not express estrogen, progesterone, or the HER-2/neu protein. After the patient underwent mastectomy, she was diagnosed with a low-grade mucoepidermoid carcinoma based on the clinical, histologic, and immuno-phenotypic characteristics. Our findings provide further insight into the pathologic mechanism of MEC, as correct diagnosis is essential for patient management.     

涎腺粘液表皮样癌78例临床分析

目的探讨涎腺粘液表皮样癌的诊断、治疗和减少术后复发率有效方法。方法回顾性总结分析经病理证实的78例涎腺粘液表皮样癌患者的临床资料,对发病年龄、临床表现、手术方法和诊断等进行总结分析。结果涎腺粘液表皮样癌术后随访1~10年,腮腺区复发5例(11.3%),腭部区复发1例(6.25%),发生在颌下区和其他部位的无复发。结论涎腺粘液表皮样癌术前诊断困难,易造成误诊。术中快速冰冻明确诊断、确定手术范围是减少术后复发率有效方法。     

Oncocytic mucoepidermoid carcinoma of the parotid gland: report of a case with DNA ploidy analysis and review of the literature

A 44-year-old female presented with a painful mass in the left parotid gland. Histologic examination revealed the characteristic picture of oncocytic mucoepidermoid carcinoma (OMEC) composed mainly of sheets of oncocytic cells with uniform nuclei and eosinophilic cytoplasm, focally smaller epidermoid cells surrounding poorly formed glandular spaces, and a few cystic structures lined by well-differentiated mucous cells with intracytoplasmic mucin. Immunohistochemical staining with antimitochondrial antibody showed granular cytoplasmic positivity in oncocytic cells. The resulting histogram for DNA ploidy analysis was of diploid type. OMEC of the parotid gland is a recently described rare neoplasm. Only six cases have been previously reported in the literature. For an accurate approach in the management of patients, OMEC should be considered in the differential diagnosis of oncocytic lesions of the parotid gland, most of which are benign.     

Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid gland in a male patient: a case report and literature review

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) was first described by Chan et al in 1991. It is characterized by nest or strands of epidermoid tumor cells with squamous differentiation, rare mucous cells, prominent sclerotic stroma, eosinophilic and lymphoplasmacytic infiltration, and a background of chronic lymphocytic thyroiditis in the non-neoplastic thyroid gland. It is important to recognize SMECE of thyroid and differentiate it from squamous cell carcinoma or other neoplasms with squamous differentiation/metaplasia. In published cases, the SMECE of thyroid gland predominantly occurs in women. We report a case of SMECE of thyroid in a 45-year-old male patient. All cases in male patients were Caucasian described in English literature, and our case is the first one in Asian.