同侧腮腺Warthin瘤合并腺泡细胞癌临床病理观察

Warthin tumor with acinic cell carcinoma of the parotid gland

目的提高对唾腺多发肿瘤的认识和警惕性,探讨Warthin瘤和腺泡细胞癌的起源。方法采用HE染色和免疫组化染色,观察1例同侧腮腺Warthin瘤合并腺泡细胞癌的病理形态及CK7、CK19、34βE12和Ki-67等的表达,并结合文献进行复习讨论。结果腮腺深部肿瘤最大径2·7cm,为典型的Warthin瘤组织结构;同侧腮腺浅叶内结节最大径0·8cm,组织学为腺泡细胞癌;Warthin瘤上皮成分和腺泡细胞癌CK7、CK19和34βE12均(+),但前者分布有规律,后者分布紊乱,其表达与正常腮腺组织的小导管和闰管上皮相似。结论同侧腮腺同时发生Warthin瘤和腺泡细胞癌十分罕见,免疫组化支持腮腺Warthin瘤和腺泡细胞癌起源于未梢导管细胞或“多潜能”储备细胞的观点。

Objective To report a case of Watthin ttanor complicated with acinic cell carcinoma in the parotid gland and to investigate their hiatogeneais. Methods Clinicopathologic featurea and immunohistochemistyr of CKT, CK19, 3413E12 and Ki- 67 were observed with review of the literatures. Results Two tumors were presented in the parotid gland of the same side. One was situated in the deep portion with 2.7 on in its greatest dimension. The histalogy showed a typical Warthin tumor. In the shallow portion of the same parotid gland, a nodule of 0.8 cm in greatest dimension was noted. The histology revealed an acinic cell carcinoma. Both ttanora expressed CK7, CK19, 34βE12, similar to those in the normal terminal ducts and intercaiated cells. Conclusions Collision tumor of Warthin tumor and acinic cell carcinoma in the same parotid gland is extremely rare. The fmdings support the histogenesis of terminat ducts or multipotential ceils.