以肌上皮增生为主的泪腺多形性腺瘤临床病理分析

目的：探讨以肌上皮增生为主的泪腺多形性腺瘤的病理形态特征及诊断、鉴别诊断。方法：30例经病理诊断为泪腺多形性腺瘤患者石蜡切片标本,应用HE染色及免疫组化标记,观察病变特点。结果：光镜下观察多形性腺瘤的基本病理改变为腺上皮细胞和肌上皮细胞以及间质成分混合存在,腺上皮细胞可排列成腺管状、条索状和实体状;免疫组化标记结果：导管上皮CK+、CK5/6+、CK7+、CK20-,肌上皮Actin+、SMA+、P63+、Desmin-,其它标记物导管外层肌上皮细胞和粘液软骨样细胞S-100+、Vimentin+、P53+,Ki-67阳性细胞数＜2%,CD34-。结论：泪腺多形性腺瘤细胞中小灶状的腺管结构及粘液软骨样基质是诊断的重要线索,免疫组织化学染色对诊断及鉴别诊断也具有参考价值。     

大肠癌组织P53蛋白与PCNA的表达及意义

目的　研究P5 3蛋白及PCNA在结直肠肿瘤中的表达及意义。方法　使用结直肠手术切除标本 2 15例 ,全部作常规病理检查及免疫组化检查。使用P5 3与PCNA单抗即溶型试剂用S P法作酶标染色。结果　在高、中、低分化腺癌及DukesA、B、C分期中P5 3阳性率分别为 5 5 8%、70 6 %、95 5 % (P <0 0 0 1)及 6 6 7%、76 5 %、82 9% (P <0 0 5 )。PCNA强阳性率分别为 4 6 5 %、6 0 0 %、77 4 % (P <0 0 5 )及 4 1 7%、6 1 2 %、6 4 3% (P <0 0 1)。结论　P5 3及PCNA表达对癌组织的分化程度及显示病程进展转移的临床病理分期均呈正相关。     

涎腺肿瘤免疫组化研究

应用6种抗体(CEA、MAK-6、EMA、S-100、GFAP、HHF-35)对55例涎腺肿瘤和9例肿瘤旁涎腺组织进行免疫组化研究,结果表明:肿瘤旁涎腺组织的免疫光谱,以腺管上皮细胞为一端,肌上皮细胞为另一端,润管细胞和腺泡细胞位于光谱中间段,多形性腺瘤起源于同一类细胞,而不是混合性起源。简略介绍HHF-35的性质和应用价值,在识别肌上皮细胞方面,HHF-35比GFAP更为敏感。     

Muscular hamartoma of the breast

Summary A rare case of muscular hamartoma of the breast was presented. An electron microscopic study confirmed that the proliferating spindle cells were of smooth muscle cell origin.     

肌上皮细胞和基底膜在乳腺良恶性病变中存在的形式和意义

甲平滑肌肌动蛋白(ASMA)是肌上皮细胞和基底膜非常特异的阳性表达物。乳腺良性病变和非浸润癌的导管外周阳性物完整的呈袖口状围绕。乳腺增生病腺上皮细胞不典型增生和小叶原位癌因细胞过度增生压迫管壁致阳性物萎缩。乳腺增生病的纤维硬化型管周阳性物被挤压断裂。导管浸润癌始发处管周阳性物破坏。肌上皮和基底膜完整或破坏对鉴别诊断和预后估计有意义。未见癌细胞分化形成肌上皮和基底膜;见到几处肌上皮细胞向纤维细胞分化。     

Characterization of cytoskeletal proteins in basal cells of human parotid salivary gland ducts

Summary From previous immunofluorescent, immunohistochemical and ultrastructural studies, myoepithelial cells have been reported to be absent from the striated and excretory ducts of human salivary gland. Yet recently, certain anti-cytokeratin monoclonal antibodies which specifically label the myoepithelium of salivary gland acini and intercalated ducts have also been found to stain basally situated cells in both striated and excretory ducts. In this study, we have used eight samples of normal human parotid gland (methacarn-fixed and frozen sections) to establish if basal cells of striated and excretory ducts have the cytoskeletal protein complement (actin and cytokeratins) of myoepithelial cells. Using a muscle-specific actin, HHF35, not only is the myoepithelium of acini and intercalated ducts stained in all cases, but stellate and spindle shaped cells are also detected all along the inter- and intralobular striated ducts in four of the eight examples. With double-labeled frozen sections and fluorescent microscopy, the actin-specific probe, phalloidin, and the myoepithelial-selective anti-cytokeratin 14 antibody, 312C8-1, confirm that the striated duct does have a population of basal cells with the cytoskeletal protein make-up of myoepithelium. The monoclonal antibody 8.12 (specific for cytokeratin 13 and 16) also stains some basal cells of striated and excretory ducts, as well as luminal cells of ducts at all levels, but does not label the myoepithelium of acini and intercalated ducts. Both the anti-cytokeratin antibodies and the actin-detecting mechanisms reveal that the basal cell population of striated and excretory ducts is more heterogeneous, and likely functionally more complex, than has been realized previously. Such findings are not in agreement with certain aspects of current theories of the histogenesis of salivary gland tumours.The authors appreciate the funding provided by the Moe Levin Family Foundation, Montreal, Canada     

Adenomyoepithelial adenosis and low-grade malignant adenomyoepithelioma of the breast

Summary Adenomyoepithelial adenosis of the breast is a form of adenosis not previously described. It is similar in several ways to microglandular adenosis, but one significant difference is the presence of myoepithelial cells. The present case originated as adenomyoepithelial adenosis in a 46-year-old woman. In the course of 18 years it proliferated and changed into a low-grade malignant adenomyoepithelioma. Electron microscopy confirmed the presence of myoepithelial cells in the adenosis, and immuno-histochemical study demonstrated cells containing actin (representing myoepithelial cells) in the adenosis as well as in the adenomyoepithelioma.     

乳腺腺肌上皮瘤临床病理观察

目的 探讨乳腺腺肌上皮瘤的临床及病理组织学特征。方法 应用光镜观察及免疫组化染色对1例乳腺腺肌上皮瘤进行临床病理分析，同时复习相关文献。结果 肿瘤主要由上皮细胞和肌上皮细胞两种成分构成，前者构成管状结构的内层，后者构成管状结构的外层以及实性区域。两种细胞成分的免疫组化表达不同，前者表达CK、EMA、GCDFP-15，后者表达SMA、S-100、p63、calponin。结论 乳腺腺肌上皮瘤是一种罕见而独特的病变，属于良性肿瘤，诸多方面尚有待于进一步探讨。     

Adenomyoepithelioma of the breast associated with low-grade adenosquamous and sarcomatoid carcinomas

Six cases of invasive breast carcinoma with unusual morphological features are reported. The ages of the female patients ranged from 46 to 79 years (mean 60.5). All tumours had areas typical of an adenomyoepithelioma. In three cases adenomyoepithelioma gradually merged with low-grade adenosquamous carcinoma. In the other three patients a sarcomatoid carcinoma was associated with adenomyoepithelial areas. A common origin is proposed for these neoplasms, which extends the morphological spectrum of epi-myoepithelial cell tumours.Source of financing: National Research Council (CNR, Rome). Project ACRO and MURST 40% and 60%