腮腺非皮脂腺淋巴腺瘤2例并文献复习

Nonsebaceous lymphadenoma of salivary gland:report of two cases and review of the literature

目的探讨非皮脂腺淋巴腺瘤(nonsebaceous lymphadenoma,NSL)的临床病理学特征、诊断及鉴别诊断。方法分析2例NSL的临床病理学特征、组织学形态及免疫表型并复习相关文献。结果 2例NSL均为成年女性。镜检:肿瘤主要由上皮成分及间质增生的淋巴组织混合形成,与周围腮腺组织界限清楚,由纤维结缔组织分隔,间质内可见增生的淋巴滤泡。上皮成分可由囊腔、实性岛状、梁状或腺管样结构组成,其中囊腔及腺管样结构由两种细胞成分构成,腔面细胞及外层细胞,囊腔内含伊红不定形物及偶见的泡沫细胞,上皮细胞无皮脂腺分化,形态温和,无非典型性,未见核分裂象。其中1例见完整的纤维被膜包绕整个肿瘤,被膜下见窦结构。免疫表型:上皮细胞CK(AE1/AE3)和CK7阳性,囊腔、腺管样结构的外层细胞p63、CK34βE12和CK5/6阳性。结论 NSL是一种罕见的涎腺良性肿瘤,位于淋巴结内的病变报道较少,组织学结构的多样性使其易与一些涎腺病变相混淆,与一些恶性肿瘤的鉴别尤为重要。

Purpose To investigate clinicopathological features, diagnosis and differential diagnosis of non-sebaceous lymphadenoma of the parotid gland. Methods The histopathological morphology, immunohistochemical profiles and clinicopathological features were an-alyzed in two cases of NSL, along with review the related literatures. Results Two patients were female adults. Microscopically, The tumor was a well-circumscribed mass surrounded by a fibrous capsule of variable thickness and comprised a mixture of proliferating epi-thelium accompanied by a prominent lymphoid component, reactive lymphoid follicles were found in lymphoid stroma. The epithelial component took the form of anastomosing trabeculae, glands, solid basaloid islands or cyst formation. The cysts and glands were lined with luminal cells and abluminal cells, filled with eosinophilic secretions with occasional histiocytes. The epithelial cell was no seba-ceous differentiation, significant cytological atypia and mitotic activity. A fibrous capsule with subcapsular sinus was seen around the mass in one case. Immunohistochemically, the abluminal cells were positive for p63, CK34βE12 and CK5/6, while the epithelial cells were positive for CK（AE1/AE3） and CK7. Conclusion NSL is a very rare benign of salivary gland, which occuring in the lymph node lesions are less reported, knowledge of the wide histological spectrum of this rare tumor is important in order to avoid misdiagno-sis, particularly as malignant tumor.