腮腺分泌性癌2例临床病理分析

Secretory carcinoma of the parotid gland:clinicopathological features of 2 cases

目的探讨涎腺分泌性癌(mammary analogue secretory carcinoma,MASC)的临床病理特征。方法收集2014年1月至2020年4月于武汉大学人民医院潜江医院就诊的16例涎腺腺癌患者病例,观察其组织学形态及免疫组织化学特点,并复习相关文献,筛选出2例涎腺分泌性癌。结果2例均为男性,发病年龄分别为17岁、42岁,均发生于右侧腮腺,均表现为无痛单发性肿块。2例组织学表现类似,镜下:肿瘤边界不清,呈分叶状结构,排列成微囊状、乳头状或筛状,胞质内可见黏液空泡和顶浆分泌,细胞核呈圆形,可见小核仁。免疫表型:2例SOX-10,S-100阳性,DOG-1,P63阴性,过碘酸-雪夫(PAS)染色阳性。结论MASC是一种少见的低度恶性涎腺上皮性肿瘤,易于误诊为涎腺腺泡细胞癌,组织学检查联合免疫组织化学染色,必要时可进行ETV6基因重排予以鉴别。

Objective To investigate the clinicopathological features of mammary analogue secretory carcinoma(MASC).Methods 16 cases of salivary adenocarcinoma admitted to Qianjiang Hospital of Wuhan University from January 2014 to April 2020 were collected and two cases of salivary secretory carcinoma were screened out.The histological and immunohistochemical features were observed and the relevant literatures were reviewed.Results Both cases were male,and the ages of onset were 17 and 42 years old,respectively.The tumors were painless single masses on the right parotid gland.2 cases had similar histological characteristics,presented unclear boundary,lobulated structure,arranged in a microcystic,papillary or cribriform structure.Mucinous vacuoles and apocrine secretion were observed in the cytoplasm,and the cell nucleus was round with visible small nucleoli.The immunohistochemical staining showed the 2 cases were positive for SOX-10,S-100 and negative for DOG-1,P63,and periodic acid-Schiff(PAS)staining was positive.Conclusion MASC is a rare low-grade malignant salivary epithelial tumor,which is easy to be misdiagnosed as salivary acinic cell carcinoma.Histomorphological observation and immunohistochemical staining,and if necessary,ETV6 gene rearrangement,can be performed to assist in differential diagnosis.