下咽部原发性恶性颅咽管瘤1例报道及文献复习

目的：报告首例下咽部原发性恶性颅咽管瘤并探讨其组织发生。方法：对1例男性患者的全喉及左甲状腺肿瘤作组织学观察，重点观察肿瘤与正常组织交界处的病变。免疫组化检测Ki-67、p53、CEA、c-erbB-2和抗端粒酶（TRT）抗体的表达。对鞍下颅咽管瘤作文献复习和讨论。结论：肿瘤原发于左侧下咽部环后区，系典型的造粒酶细胞瘤型颅咽管瘤，瘤细胞有异型性，广泛浸润下咽周围软组织及左侧甲状腺。癌瘤与正常组织交界处有移行现象。表达Ki-67、p53、c-erbB2和端粒酶活性，CEA阴性。结论：本例系下咽部原发性恶性颅咽管瘤，首次证明局部黏膜上皮（基底细胞）可发生颅咽管瘤。

Malignant craniopharyngioma of the hypopharynx:a case report and review of the literature

Objective To report the first case of primary malignant craniopharyngioma in the hypopharynx and to discuss its histogenesis. Methods The specimen of the resected whole laryngeal and thyroid tumors in an old-male patient was examined using routeine tissue slices with hematoxylin and eosin staining. The study was focused on the transitional lesions between tumor and normal tissue. Immunostaining was performed to detect the expression of Ki-67, p53 ,CEA, c-erbB-2 (LSAB protocol)and telomerase (ABC protocol). The related literature was reviewed. Results The tumor with typical histopathologic features of adamatinomatous craniopharyngioma arose from cricoid cartilage posterior area on the left. The tumor cells appeared atypical morphology,and was widely infiltrated the surrounding soft tissue of the hypopharynx and left thyroid. The morphological transition was observed in the junction area of the normal tissue and tumor. Ki-67, p53, c-erbB-2 and teromerase (TRT) showed enhanced expression. CEA was negative. Conclusions Malignant craniopharyngioma is primary hypopharyngeal neoplasm rising in the basal layer cell of the squamous cell epithelium of the local mucous membrane. It is the first case to indicate that the ectopic craniopharyngioma in the pharynx may originate from epithelial cells of local mucous membrane.