腮腺原发淋巴上皮癌病理特点分析

Clinic- pathologic study of primary lymphoepithelial carcinoma in the parotid glands

目的探讨腮腺淋巴上皮癌(LEC)的临床病理特点、免疫组化表型及鉴别诊断。方法收集11例腮腺LEC临床病理资料,进行形态学、免疫组化及原位杂交检测,并复习相关文献。结果腮腺LEC光镜下肿瘤细胞均呈浸润性生长,排列成片状、岛状和条索状;肿瘤细胞边界不清楚,嗜酸性胞质淡染,泡状核呈椭圆形,染色质空,核仁明显;间质为成熟淋巴细胞和浆细胞,常伴有反应性淋巴滤泡增生。5例伴有颈部淋巴结转移,2例伴有神经纤维侵犯。免疫组化检测肿瘤细胞CK、EMA、CK5/6、P63抗体阳性,Vimentin、LCA、CD56抗体阴性;原位杂交检测EBER 10例阳性,1例阴性。结论腮腺LEC是腮腺未分化癌的少见亚型,肿瘤组织由恶性上皮岛和淋巴样组织构成,EBER检测有助于诊断。

Objective To study the clinicopathologic characteristics , immunophenotype and differential diagnosis of primary lymphoepithelial carcinoma （ LEC） in the parotid glands .Methods The pathologic features of 11 parotid LEC pa-tients were collected to adopt the immunohistochemical and situ hybridization （ISH） staining test.Results LEC tumor cell present a parotid swelling feature , with sheets , islands and cords array .The tumor cells possess indistinct cell borders , lightly eosinophilic cytoplasm , oval vesicular nulei with open chromatin and conspicuous nuclei .The tumor is infiltrated by lymphocytes and plasma cells , with some accompanied by reactive lymphoid follicles .Metastases to the cervical lymph nodes were found in 5 patients and perineural invasion were found in 2 patients.CK, EMA, P63 and CK5/6 were both pos-itive and Vimentin, LCA,CD56, S-100 were negative in all 11 cases.The EBER was found positive in 10 cases by method of ISH.Conclusion LEC is a rare subtype of undiferentiated carcinoma in the parotid glands .The tumor tissue of LED was composed by malignant epithelial island and lymphoid stroma .LEC test is helpful for pathologic diagnosis of LEC .