腮腺多形性腺瘤合并癌的病理学研究

HISTOPATHOLOGICAL STUDY ON CARCINOMAS IN PLEOMORPHIC ADENOMAS IN PAROTID

762例腮腺上皮性肿瘤中癌占1.84％。除细胞间变外,下述组织学发现对癌的诊断至关重要:①包膜浸润。②癌细胞浸润邻近组织。③瘤组织中软骨样基质及纤维组织内典型细胞增生。④血管浸润。⑤核分裂相增多。良性瘤女性多见计397例(77.5％),年龄31～52岁(49.8％),而此瘤之合并癌者则以男性多见(66.7％),并常见于50岁以上。组织学类型:未分化癌多见(55.4％),腺癌仅占35.6％。一般认为未分化癌的预后较差。

Seven hundred and sixty-two cases of primary epithelial cell tumors in the parotid were studied. The incidence of carcinomas in pleomorphic adenomas was 1.8%. In addition to cellular atypism, the following histological findings were thought to be important criteria for the diagnosis of carcinomas. 1) capsular infiltration,2) infiltration into adjacent tissues, 3) proliferation of atypical cells within fibrous tissues and chondroid matrix in pleomorphic adenomas, 4) vascular infiltration, 5) increased mitotic figures. Pleomorphic adenomas(397 cases) were found mainly in females of 31-52 of age (49.8%) , whereas carcinomas in pleomorphic adenomas were more commonly found in males of the age over 50(44.3%). The prognosis of the undifferentiated types was generally poor.