支气管上皮-肌上皮癌临床病理观察

Epithelial-myoepithelial carcinoma of the bronchus: a clinicopathological observation

目的探讨支气管上皮-肌上皮癌(epithelial-myoepithelial carcinoma,EMC)的临床病理学特点、诊断及鉴别诊断。方法采用HE、免疫组化SP法对4例支气管EMC的标本进行组织学观察及免疫组化标记,并分析病理组织学形态和免疫表型。结果 EMC由内层腺上皮及外层肌上皮构成,呈双套管结构。腺上皮成分CK、EMA均呈阳性,肌上皮成分Calponin、p63、CK、CD117、S-100、GFAP均呈阳性。结论原发于支气管的EMC临床罕见,多数位于大支气管内,诊断依靠组织学形态及免疫表型,应与黏液表皮样癌、腺样囊性癌、多形性腺瘤转移性透明细胞癌鉴别。EMC治疗以手术切除为主,但也可复发或转移。

Purpose To investigate the features of pathological characteristics and differential diagnosis of epithelial-myoepithelial car- cinoma （EMC） of the bronchial. Methods Four cases of EMC of the bronchus were studied by light microscope and immunohisto- chemistry of SP. The morphological and immunohistochemical features was analyzed. Results The tumor demonstrated a double-laye- ring glandular structures consisted of epithelial and myoepithelial cells. The inner layer was lined by adenoid cells and outer layer by myoepithelial cells. Immunohistochemical staining showed that the adenoid cells were positive for CK, EMA and myoepithelial cells were positive for Calponin, 1363, CK, CDll7, S-IO0, GFAP. Conclusion The primary EMC in the bronchial is a very rare tumor with only occured in the big bronchus. The diagnosis is based on histopathological characteristics and immunohistochemical staining. It should be differentiated from other lesions of the bronchial, including mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomor- phic adenoma and metastatic clear cell carcinoma. For the treatment of the EMC, surgical excision can cure the disease, but some can also be a recurrence or metastasis.