涎腺腺样囊性癌氩离子激光流式细胞术分析及其临床意义

为探讨流式细胞术对涎腺腺样囊性癌的诊断和预后估计的价值，对４１例腺样囊性癌行流式细胞术分析。结果，平均ＤＮＡ指数为１．１７９，Ｓ期细胞比例为２９．４９％，细胞增殖指数为４２．６７％，均明显高于正常组织。异倍体检出率为７０．７３％。随着肿瘤的增大和恶性程度的增加，其异倍体率、ＤＮＡ指数和Ｓ期细胞比例值也相应增加。流式细胞术为涎腺腺样囊性癌的病理诊断和确定恶性程度提供了有效的辅助诊断措施，但尚不能判断预后。     

Adenoid cystic carcinoma of the breast diagnosed by fine-needle aspiration

Fine-needle aspiration cytology remains a useful tool for preoperative diagnosis of breast lesions. We describe a case of adenoid cystic carcinoma (ACC) of the breast detected by ultrasound-guided fine-needle aspiration (FNA). Subsequent histopathology corroborated the diagnosis. ACC is a rare but distinctive neoplasm of the breast that can be accurately diagnosed by FNA. Its infrequent presentation, favorable prognosis, and relatively conservative management in the breast prompt us to reinforce its features.     

Lymphoid and non-lymphoid cells in the adenoid of children with otitis media with effusion: a comparative study

We characterized on immuno- and enzymecytochemical level the lymphoid and non-lymphoid cells in the adenoid of children with upper respiratory tract infections (URI) and otitis media with effusion (OME) and compared these with the adenoid of children with URI without OME and with the adenoid of 'healthy' children and adults. Besides macrophages and dendritic cells we also showed the presence of MHC class II positive, ciliated, epithelial cells. These non-lymphoid cells were present in all adenoids. However, their number was less than 1% of all cells. We found no difference in lymphocyte subsets from children with URI + OME compared with those from children with URI alone. These two groups showed a significant decrease of CD8-positive (suppressor/cytotoxic) cells and a slight increase in CD22-positive B cells in comparison to 'healthy' children. No difference was found in percentages of CD4-positive (helper/inducer) cells. The localization of the lymphoid subsets in adenoids of children with URI and/or OME did not differ from those of 'healthy' children and adults.     

Polymorphous low-grade adenocarcinoma of submandibular gland origin

A case of polymorphous low-grade adenocarcinoma (PLGA) in the submandibular gland is reported. A 72 year old woman presented with a 5 year history of a gradually expanding tumor in the submandibular region. The surgical specimen revealed a relatively well demarcated tumor, 35 × 35 × 20 mm in size. Macroscopically, necrosis and hemorrhage were not seen in the solid tumor. Histologically, the tumor growth pattern was variable, composed of tubular, papillary, solid, trabecular and cribriform structures. Immunohistochemically, some tumor cells were positive for epithelial membrane antigen (EMA), S-100 protein, keratin, and carcino-embryonic antigen (CEA). Electron microscopically, prominent microvilli projected into the luminal spaces, and basal lamina and hemidesmosomes were seen in the tumor cells adjacent to the connective tissues. The submandibular gland is an extremely rare location for PLGA. To the authors' knowledge, this is the first case of its kind reported in the English literature.     

Primary pulmonary adenoid cystic carcinoma: report of a case diagnosed by fine-needle aspiration cytology

Adenoid cystic carcinoma of the lower respiratory tract is an uncommon tumor that can arise in the mainstem bronchus and often presents as an endobronchial mass lesion causing bronchial obstruction with post obstructive atelectasis and pneumonia. Exfoliative cytology is seldom useful in the diagnosis of primary bronchial adenoid cystic carcinoma, because these neoplasms usually have a submucosal location with often intact mucosa. Since most endobronchial adenoid cystic carcinomas are endoscopically visible, bronchoscope-guided fine-needle aspiration constitutes an excellent approach to establish a pathologic diagnosis. The fine-needle aspiration cytology of primary pulmonary adenoid cystic carcinoma has been rarely described. We report a case of primary adenoid cystic carcinoma of the lung having characteristic cytologic features and correlate with computed tomography, bronchoscopic, and histological findings. Bronchoscope-guided aspiration cytology provided a conclusive diagnosis of adenoid cystic carcinoma, which was further corroborated by histology in the pneumonectomy specimen. Diagn. Cytopathol. 2004;30:51-56.     

涎腺腺样囊性癌高、低转移细胞系基因表达谱及基质金属蛋白酶表达差异

目的筛选与涎腺腺样囊性癌转移相关的候选基因，并对其中的候选基因进行初步的验证。方法用限制片段差异显示PCR技术（restriction fragments differential display PCR, RFDD-PCR）建立涎腺腺样囊性癌高、低转移细胞株（ACC-M、ACC-2）的表达谱。对两个表达谱的片段进行比较，通过生物信息学的分析，初步筛选出候选基因。用半定量逆转录PCR技术对筛选出的基因进行初步验证。结果RFDD-PCR方法共获得5420个基因片段，其中包含12个基质金属蛋白酶（matrix metalloproteinase，MMP）基因。半定量逆转录PCR方法发现MMP2、MMP7、MMP9、MMP14、MMP15、MMP24在ACC-M和ACC-2中的表达存在明显差异。结论构建了ACC-M和ACC-2细胞株的表达谱，为寻找目的基因奠定了基础。发现MMP2、MMP7、MMP9和MMP15与涎腺腺样囊性癌的发生、发展、转移有关，不同肿瘤细胞的转移能力可能与不同的MMPs家族基因相关。     

Electron Microscopic Study of Adenoid Cystic Carcinoma

This ultrastructural study is based on nine cases of adenoid cystic carcinoma arising from the salivary glands. Electron microscopically, the tumors consisted of five cell types: relatively differentiated intercalated duct cells, secretory cells, undifferentiated cells, cells of a squamous nature, and myoepithelial cells. Special attention was paid to the characteristic extracellular substances noted by light microscopic examination of these tumors. The hyaline material of the pseudocysts contained not only mucopolysaccharide granules but also fingerprintlike structures formed by replicated basement membrane. Some of these structures had a dense core, probably composed of mucopolysaccharide granules. Cell islands surrounded by elasticlike material also were found. The true lumina were usually filled with membranovesicular structures originating from fragments of the lining cells, mainly those with squamous differentiation. These membranovesicular structures included electron-dense rods, filamentous whorls, and structures displaying periodicity.     

腮腺腺样囊性癌病人血浆P—选择素的测定

①目的　探讨可溶性P 选择素 (sP selectin)与腮腺腺样囊性癌发展及转移的关系。②方法　用ELISA法检测 6 5例腮腺腺样囊性癌病人血浆中sP selectin的含量。③结果　腮腺腺样囊性癌病人血浆中sP se lectin的含量均明显高于正常对照组 (t=- 12 .6 5 ,P <0 .0 1) ;而且血浆中sP selectin的水平与病情发展有关 (F =92 .6 7,q =5 .6 0 2～ 13.45 3,P <0 .0 1)。 ④结论　sP selectin检测有可能成为腮腺腺样囊性癌病人辅助诊断、观察病情发展的一项有价值的指标。     

53例涎腺腺样囊性癌MMP—2和MMP—9表达与神经浸润和淋巴结转移的关系

目的研究涎腺腺样囊性癌MMP-2和MMP-9表达情况,评估其与涎腺腺样囊性癌神经浸润和淋巴 结转移的关系。方法选取53例涎腺腺样囊性癌,以抗MMP-2和MMP-9单克隆抗体用Envision法进行免疫 组织化学染色和半定量分析。结果MMP-2和MMP-9在涎腺腺样囊性癌中的表达率分别为67.92％和 79.25％;有神经浸润的腺样囊性癌其MMP-2和MMP-9的表达水平远高于无浸润者(P＜0.05,P＜0.05);随 着MMP-2和MMP-9的表达水平增高,淋巴结转移率也增高(P＜0.05,P＜0.05)。结论提示MMP-2和 MMP-9的高表达与涎腺腺样囊性癌易侵犯神经的特性及发生淋巴结转移密切相关。